Reason Code 5NPDN - JF Part A

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 documentation
  • Corrected UB-04 form

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

Resource

• Remittance Advice Remark Code List

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