© 2019 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.
Printed Date: 9/22/2015
Denial Reason, Reason/Remark Code(s)
First: Verify the status of your claim before resubmitting. You can determine the status of a claim through the Palmetto GBA's eServices portal or by calling the Palmetto GBA Interactive Voice Response unit (IVR).
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.
One important consideration: 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 User Manual (PDF, 8 MB)
Physicians in the same group practice who are in the same specialty must bill and be paid as though they were a single physician. When more than one E/M service is provided to the same patient on the same date by more than one physician in the same specialty in the same group, only one E/M service may be reported unless the E/M services are for unrelated problems. Physicians in the same group practice but who are in different specialties or subspecialties may bill and be paid without regard to their membership in the same group.
We strongly encourage all providers and their staff members to become familiar with the E/M Documentation Guidelines, which were developed jointly by CMS and the American Medical Association.
We value your opinion and want to provide the highest-quality and most relevant Medicare knowledge possible. Please let us know if this article was helpful.
It didn't answer my question
This article was helpful
We’re glad we could help you today and appreciate your feedback. When you rate our articles as most helpful, we know that we are on the right track for providing you with important news and information.
We're sorry this article didn't help you today. We'll use your feedback to review this article to try to revise or expand it. Contact us with more feedback or a question on this topic.
Last Updated: 03/29/2018