Reason Code 151 - JD DME
Reason Code 151
|Reason Code: 151||Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.|
Common Reasons for Denial
- Equipment is the same or similar to equipment already being used.
- There is a date span overlap or overutilization based on related LCD.
- A Redetermination request may be submitted with all relevant supporting documentation. Noridian encourages Redeterminations/Appeals be submitted using the Noridian Medicare Portal. Review applicable Local Coverage Determination (LCD), LCD Policy Article, and Documentation Checklists prior to submitting request. Noridian encourages Redeterminations be submitted using the Noridian Medicare Portal
How to Avoid Future Denials
- Prior to providing equipment, an Advance Beneficiary Notice of Noncoverage (ABN) may be obtained for items a supplier knows a beneficiary does not qualify for
- To verify if beneficiary has/has not had a same or similar item in the past, suppliers may use the Noridian Medicare Portal or Noridian Interactive Voice Response (IVR) System @ 866-419-9458
Last Updated Tue, 10 Nov 2020 18:33:40 +0000