Reason Code 16 | Remark Codes MA66

Code Description
Reason Code: 16 Claim/service lacks information or has submission/billing error(s)
Remark Code: MA66 Missing/incomplete/invalid principal procedure code

 

Common Reasons for Denial

  • Item billed was missing or had an incomplete/invalid procedure code

Next Step

  • Correct claim and resubmit claim with a valid procedure code listed on the PDAC website

How to Avoid Future Denials

  • Ensure that all claim lines have a valid procedure code prior to billing for the date of service billed as listed on the PDAC website
  • Update software systems as necessary to ensure claims are billed with current procedure code

 

Last Updated Dec 09 , 2023