Reason Code 55406 - JE Part A
Reason Code 55406
Reason Code Narrative
THE INFORMATION PROVIDED DOES NOT SUPPORT THE LEVEL OF SERVICE AS SHOWN ON THE CLAIM.
Common Reason Code Errors
- Information received from the Additional Document Request (ADR) does not support the level of service(s) provided.
Common Reason Code Corrections
- A Redetermination request may be submitted if facility feels that sending additional documentation will support need for service(s) provided.
- Redetermination should include:
- All applicable supporting medical documentation
- Corrected UB-04 form
- Redetermination should include:
Direct Data Entry (DDE) users can view the remarks section for additional clarification.
Resource
View reason code list, return to Reason Code Guidance page.
Last Updated Fri, 30 Dec 2022 21:02:16 +0000