Reason Code 5NPDN

Reason Code Narrative

THE INFORMATION PROVIDED DOES NOT SUPPORT THE NEED FOR THIS SERVICE OR ITEM.

Common Reason Code Errors

  • Information billed does not support the need for item or service billed

Common Reason Code Corrections

  • A Redetermination may be submitted if facility feels that sending additional documentation will support need for service(s) provided. Request should include:
    • All applicable supporting medical documentatio
    • Corrected UB-04 form

Direct Data Entry (DDE) users can view remarks section for additional clarification.

Resource

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

Last Updated May 22, 2018