|PR-49||This is a non-covered service because it is a routine/preventive exam or a diagnostic/screening procedure done in conjunction with a routine/preventive exam. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.|
|N111||This service was included in a claim that has been previously billed and adjudicated.|
Common Reasons for Message
- Routine examinations and related services are not covered.
- Verify proper diagnosis was submitted
- Submit an Appeal request - Items or services with this message have appeal rights
- Submit documentation with Redetermination request. View Medical Documentation Requirements
Claim Submission Tips
- Allow 30 days from first claim submission before resubmitting
- Check claim status via Interactive Voice Response (IVR) or the Noridian Medicare Portal
View reason code list, return to Reason Code Guidance page.
Last Updated Nov 15, 2017