Medicare EOB reason codes - Part 2

CO ContraƧtual Obligation. Amount for which the not be billed for this amount.

The difference between billed amount and allowed amount. It should be written off.

Patient esponsibility. Amount that may be billed to a patient another payer

Usually deductible and coins. Bill patient or secondary if patient has.

B10 Allowed amount has been reduced because a component of the basic procedure/test was paid. Beneficiery is not liable for more than the charge limit for the basic procedure/test.

If one or more surgery or procedure performed then Medicare will reduce

second procedure reimbursment. Just go by EOB.

109 Claim not covered by this payer/contractor. You must send the claim to the correct payer

Check the eligibility and send the claim to correct payor.

150 Payer deems the information submitted does notsupport this level of service.

Check the dx and if required submit medical records.

23 The impact of prior payer(s) adjudication including payments and/or adjustments.

This is seondary claim so Medicare only pay whatever the primary insurance left off.

24 Charges are covered under a capitation agreement/Managed care plan.

Check the eligibility and submit the claim to HMO.

Simillar Links.

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