Reason Code 96 | Remark Code N115 - JA DME
Reason Code 96 | Remark Code N115
|Reason Code: 96||Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.|
|Remark Code: N115||This decision was based on a Local Coverage Determination (LCD). An LCD provides a guide to assist in determining whether a particular item or service is covered. A copy of this policy is available at www.cms.gov/mcd, or if you do not have web access, you may contact the contractor to request a copy of the LCD.|
Common Reasons for Denial
- Medicare does not pay for this item or supply.
- A redetermination request may be submitted with all applicable supporting documentation. Review the applicable Local Coverage Determination (LCD), LCD Policy Article, and documentation checklists prior to submitting the redetermination. Noridian encourages redeterminations be submitted using the Noridian Medicare Portal.
How to Avoid Future Denials
- Review the applicable Local Coverage Determination (LCD), LCD Policy Article.
Last Updated Mon, 02 Jul 2018 12:48:48 +0000