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 documentation
    • 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 Wed, 13 May 2020 19:36:12 +0000