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Printed Date: 9/22/2015
This claim line was submitted by the provider as non-covered. Providers are liable for these denials unless a specific modifier or indicator (i.e., occurrence code 32) on the claim attaches liability to the beneficiary.
This is a valid processing reason code. It does not reflect incorrect billing. Condition code (CC) 20, 21 or occurrence code (OC) 32 is not present on the claim to indicate the non-covered reason.
CMS Internet Only Manual (IOM), Publication 100-04, chapter 1 (PDF, 1.62 MB), section 60.4.2.
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Last Updated: 12/16/2019