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© 2021 Palmetto GBA, LLC

We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.

Published Date:07/02/2020

Printed Date: 9/22/2015

URL: http://palmgba.com/marlowe/redesign6/article.html


Chiropractic Manipulative Treatment Denials

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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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Last Updated: 07/02/2020

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