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Jurisdiction 11 Part A
Reason Code 30905

FISS Narrative: 

  • There is no record of processing an original claim for this adjustment
  • Verify HIC number, dates of service and cross reference DCN
  • If HIC number is wrong, a new adjustment or cancel must be submitted
  • Please correct and resubmit
  • Hardcopy submitters resubmit RTP report with corrections

Explanation and Suggestion:

  • The claim you are trying to adjust cannot be found
  • Please verify the HIC number, dates of service and the cross reference DCN
  • Please correct and resubmit
  • Hardcopy submitters resubmit RTP report with corrections

 

last updated on 05/15/2014
ver 1.0.51