Reason Code Narrative

CLAIM IS SUBMITTED OR UPDATED VIA DDE AND THE PAYER CODE IS NOT EQUAL TO 'Z'.

Common Reason Code Errors

• A Medicare Secondary Payer (MSP) claim has been submitted directly through DDE system or an attempt to correct a claim in Returned To Provider (RTP) has been made directly through DDE system.

Common Reason Code Corrections

• MSP claims must be submitted through an electronic system other than DDE. If an MSP claim submitted through an electronic system has RTP'd, a new claim with appropriate corrections must be submitted through an electronic system other than DDE.

Resource

• CMS Change Request (CR) 6426

View reason code list, return to Reason Code Guidance page.