Reason Code 5OP70: Service Is Subject to Prior Authorization and No UTN Is Present on the Claim

Published 07/23/2021

Reason code 5OP70 indicates that the service is subject to prior authorization and no UTN is present on the claim. The program indicator is present. The beneficiary has prior authorization auxiliary file.

Reason for Denial
No UTN was present on the claim.

How to Avoid This Denial

  • Submit the prior authorization for one of the five hospital outpatient department pre-authorization services prior to submitting your claim for payment
  • Be sure to include the assigned UTN