Reason Code U539I - JF Part A

Reason Code Narrative

PREVENTATIVE EXAMINATION SERVICES NOT WITHIN '12' MONTHS OF FIRST PART B ENTITLEMENT PERIOD 'G0402'.

Common Reason Code Errors

• This is a claim level reason code for claims that have all line items denied due to preventive examination services is not within 12 months of first Part B entitlement period for HCPCS code G0402.

Common Reason Code Corrections

• Verify beneficiary coverage and eligibility for Part B entitlement.
• Verify preventive service HCPCS code G0402 on Noridian Medicare Portal (NMP) for next eligible date. HCPCS G0402 is a one-time benefit and subject to frequency limitation.

Resources

• Noridian Medicare Portal (NMP)