1
Clinic visit required.
2
DX code requires 4th/5th digit or is an unspecified code.
3
Please provide consent form for surgery.
4
Missing ambulance data (to and from service location).
5
Please bill with the appropriate immunization code.
6
Procedure is inconsistent with the member’s age.
7
Resubmit with manufactures invoice/description.
8
Claim not billed according to agreed upon levels of care and/or count of days.
