Reason Code 30912 - JF Part A

Reason Code Narrative

THIS ADJUSTMENT IS ADJUSTING A CLAIM THAT HAS BEEN PREVIOUSLY ADJUSTED

Common Reason Code Errors

• This error can occur when an adjustment claim (XX7 Type of bill) is submitted and cross reference Document Control Number (DCN) entered by provider in Form Locator (FL) 64 of the UB04 form (or electronic equivalent) is either incorrect, or incomplete.
• This error can also occur when a provider submits two adjustment claims, both trying to adjust same claim.

Note: Cross reference DCN can be found on Remittance Advice (RA) of finalized claim or verified through IVR or Direct Data Entry (DDE).

Common Reason Code Corrections

• Verify DCN number is correct and complete for claim being adjusted. If it is correct and complete, DDE users may F9 claim. For this scenario, non DDE users must call Provider Contact Center (PCC).
• If DCN number for claim being adjusted is incorrect or incomplete, a new adjustment claim should be submitted with correct DCN.
• If you are a provider with access to DDE, adjusting claim directly through DDE will automatically populate correct DCN of claim being adjusted.

Resource

• DDE User Manual [PDF]

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