Reason Code 96 | Remark Codes N56 N115

Code Description
Reason Code: 96 Non-covered charge(s)
Remark Code:
N56 and N115		 Procedure code billed is not correct/valid for the services billed or the date of service billed
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

 

Common Reasons for Denial

  • Procedure code billed is not valid for the date of service on the claim

Next Step

  • Correct claim line with appropriate procedure code for date of service and resubmit claim

How to Avoid Future Denials

  • Ensure correct HCPC code is billed for date of service on claim

 

Last Updated Dec 09 , 2023