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Printed Date: 9/22/2015
A provider is not permitted to adjust a partially or fully medically denied claim.
Reason code 30940 is received when attempting to adjust a claim with a medically denied line. If you are trying to add diagnosis codes, change CPT codes or move denied charges from non-covered to covered, you must submit a Redetermination. If applicable, a provider initiated reopening TOB (XXQ) may be submitted.
SE1426 (PDF, 1 MB) — Scenarios and Coding Instructions for Submitting Requests to Reopen Claims that are Beyond the Claim Filing Timeframes — Companion Information to MM8581: "Automation of the Request for Reopening Claims Process."
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Last Updated: 12/16/2019