Reason Code 30906

Description
The incoming adjustment cannot find an original claim to match. Verify that the following fields on the adjustment are identical to those same fields on the remittance advice containing the original payment:

  • MBI Number
  • X-Rerference DCN
  • First Two Positions of the Type of Bill
  • Dates of Services
  • Provider Number

Resolution
Verify billing and if appropriate, correct. Online providers should F9 to store the claim. If these are electronically submitted adjustments, verify with your vendor that the document control number (DCN) of the claim you are adjusting is in the appropriate loop and segment. Resubmit the adjustment ensuring that the DCN is in the correct loop and segment.

Contact Palmetto GBA JM Part A Medicare


Provider Contact Center: 855-696-0705

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