Reason Code C5470

Reason Code Narrative

SERVICE IS SUBJECT TO PRIOR AUTHORIZATION AND NO UTN IS PRESENT ON THE CLAIM. THE PROGRAM INDICATOR IS PRESENT. THE BENEFICIARY HAS NO PRAU AUXILLARY FILE.

Common Reason Code Errors

  • Pending Prior Authorization Request (PAR) at Common Working File (CWF)

Common Reason Code Corrections

  • Auto-denial unless a valid UTN is supplied do not overturn

Resources

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Last Updated Apr 29 , 2025