Reason Code 109 | Remark Code N104

Code Description
Reason Code: 109 Claim/service not covered by this payer/contractor. You must send the claim/service to the correct payer/contractor.
Remark Code: N104 This claim/service is not payable under our claim’s Jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website at CMS.gov

Common Reasons for Denial

  • Claim was submitted to incorrect Jurisdiction
  • Claim must be submitted to the Jurisdiction listed as the beneficiary’s permanent address with the Social Security Administration

Next Step

  • Submit claim to correct Jurisdiction listed as beneficiary’s permanent address with the Social Security Administration. This can be verified in the Noridian Medicare Portal
  • Determine which DME MAC jurisdiction the claim is to be submitted to, based on the permanent address or should it be billed to the Part B Mac Jurisdiction

How to Avoid Future Denials

  • Check eligibility on the Noridian Medicare Portal to verify the beneficiary’s permanent address on file with the Social Security Administration
  • Identify correct DME MAC Medicare contractor to process claim, based on beneficiary’s permanent address
  • Ensure claim is submitted to correct jurisdiction, either the DME MAC or the Part B Mac Jurisdiction
  • File claims to Jurisdiction where beneficiary’s permanent residence is listed with the Social Security Administration. If changes are required, the beneficiary must contact the Social Security Administration.
Last Updated Jun 06 , 2025