Chiropractic Manipulative Treatment Denials

Published 07/02/2020

Denial Reason, Reason/Remark Code(s)
  • OA-18 - Duplicate Service(s): Same service submitted for the same patient, same date of service by same doctor will be denied as a duplicate
  • CO-151 - Information provided does not support this many/frequency of services. Same service submitted for the same patient, same date of service by the same provider will be denied. 
  • CPT codes: 98940, 98941, 98942 

Resolution/Resources
First: Verify the status of your claim before resubmitting. You can determine the status of a claim through the Palmetto GBA eServices tool or by calling the Palmetto GBA Interactive Voice Response (IVR) unit. 

Online Claim Status Verification through eServices

  • All providers that have an EDI Enrollment Agreement on file may register to use this tool. If you haven’t already registered, please consider doing so.  
  • Please note: Only one provider administrator per EDI Enrollment Agreement/per PTAN/NPI combination performs the registration process. The provider administrator can then grant permission to additional users related to that PTAN/NPI.
  • Billing services and clearinghouses should contact their provider clients to gain access to the system
  • Specific instructions for accessing claim status information through eServices are available in the eServices Users Manual (PDF, 8.33 MB)

Please note:

  • Only one chiropractic manipulative treatment will be allowed per day

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