88	Adjustment amount represents collection against receivable created in prior overpayment.
73	Administrative days.
B10 	Allowed amount has been reduced because a component of the basic procedure/test was paid. The beneficiary is not liable for more than the charge limit for the basic procedure/test.
36	Balance does not exceed co-payment amount.
37	Balance does not exceed deductible.
119	Benefit maximum for this time period or occurrence has been reached.
95	Benefits adjusted. Plan procedures not followed.
110	Billing date predates service date.
66	Blood Deductible.
84	Capital Adjustment. (Handled in MIA)
61	Charges adjusted as penalty for failure to obtain second surgical opinion.
59	Charges are adjusted based on multiple surgery rules or concurrent anesthesia rules.
40	Charges do not meet qualifications for emergent/urgent care.
42	Charges exceed our fee schedule or maximum allowable amount.
45	Charges exceed your contracted/ legislated fee arrangement.
60	Charges for outpatient services with this proximity to inpatient services are not covered.
118	Charges reduced for ESRD network support.
142	Claim adjusted by the monthly Medicaid patient liability amount.
136	Claim Adjusted. Plan procedures of a prior payer were not followed.
141	Claim adjustment because the claim spans eligible and ineligible periods of coverage.
31	Claim denied as patient cannot be identified as our insured.
20	Claim denied because this injury/illness is covered by the liability carrier.
21	Claim denied because this injury/illness is the liability of the no-fault carrier.
19	Claim denied because this is a work-related injury/illness and thus the liability of the Worker's Compensation Carrier.
A1 	Claim denied charges.
34	Claim denied. Insured has no coverage for newborns.
33	Claim denied. Insured has no dependent coverage.
135	Claim denied. Interim bills cannot be processed.
A8 	Claim denied; ungroupable DRG
D11 	Claim lacks completed pacemaker registration form.
D14 	Claim lacks indication that plan of treatment is on file.
D15 	Claim lacks indication that service was supervised or evaluated by a physician.
D16	Claim lacks prior payer payment information.
D2 	Claim lacks the name, strength, or dosage of the drug furnished.
109	Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.
92	Claim Paid in full.
131	Claim specific negotiated discount.
130	Claim submission fee.
B19 	Claim/service adjusted because of the finding of a Review Organization.
164	Claim/Service adjusted because the attachment referenced on the claim was not received in a timely fashion.
163	Claim/Service adjusted because the attachment referenced on the claim was not received.
D3 	Claim/service denied because information to indicate if the patient owns the equipment that requires the part or supply was missing.
56	Claim/service denied because procedure/treatment has not been deemed `proven to be effective' by the payer.
55	Claim/service denied because procedure/treatment is deemed experimental/investigational by the payer.
107	Claim/service denied because the related or qualifying claim/service was not previously paid or identified on this claim.
138	Claim/service denied. Appeal procedures not followed or time limits not met.
D6 	Claim/service denied. Claim did not include patient's medical record for the service.
D12 	Claim/service denied. Claim does not identify who performed the purchased diagnostic test or the amount you were charged for the test.
D7 	Claim/service denied. Claim lacks date of patient's most recent physician visit.
D8 	Claim/service denied. Claim lacks indicator that `x-ray is available for review.'
D5 	Claim/service denied. Claim lacks individual lab codes included in the test.
D9 	Claim/service denied. Claim lacks invoice or statement certifying the actual cost of the lens, less discounts or the type of intraocular lens used.
D10	Claim/service denied. Completed physician financial relationship form not on file.
D1 	Claim/service denied. Level of subluxation is missing or inadequate.
D13 	Claim/service denied. Performed by a facility/supplier in which the ordering/referring physician has a financial interest.
D4 	Claim/service does not indicate the period of time for which this will be needed.
D17	Claim/Service has invalid non-covered days.
D18	Claim/Service has missing diagnosis information.
16	Claim/service lacks information which is needed for adjudication. Additional information is supplied using remittance advice remarks codes whenever appropriate
D19	Claim/Service lacks Physician/Operative or other supporting documentation
D20	Claim/Service missing service/product information.
B8 	Claim/service not covered/reduced because alternative services were available, and should have been utilized.
148	Claim/service rejected at this time because information from another provider was not provided or was insufficient/incomplete.
127	Coinsurance -- Major Medical
2	Coinsurance Amount
72	Coinsurance day. (Handled in QTY, QTY01=CD)
139	Contracted funding agreement - Subscriber is employed by the provider of services.
A2 	Contractual adjustment.
3	Co-payment Amount
63	Correction to a prior claim.
70	Cost outlier - Adjustment to compensate for additonal costs.
79	Cost Report days. (Handled in MIA15)
28	Coverage not in effect at the time the service was provided.
B3 	Covered charges.
77	Covered days. (Handled in QTY, QTY01=CA)
B2 	Covered visits.
69	Day outlier amount.
126	Deductible -- Major Medical
1	Deductible Amount
64	Denial reversed per Medical Review.
75	Direct Medical Education Adjustment.
81	Discharges.
41	Discount agreed to in Preferred Provider contract.
91	Dispensing fee adjustment.
76	Disproportionate Share Adjustment.
68	DRG weight. (Handled in CLP12)
18	Duplicate claim/service.
27	Expenses incurred after coverage terminated.
26	Expenses incurred prior to coverage.
156	Flexible spending account payments
43	Gramm-Rudman reduction.
144	Incentive adjustment, e.g. preferred product/service.
121	Indemnification adjustment.
74	Indirect Medical Education Adjustment.
90	Ingredient cost adjustment.
85	Interest amount.
B4 	Late filing penalty.
149	Lifetime benefit maximum has been reached for this service/benefit category.
35	Lifetime benefit maximum has been reached.
67	Lifetime reserve days. (Handled in QTY, QTY01=LA)
102	Major Medical Adjustment.
104	Managed care withholding.
A5 	Medicare Claim PPS Capital Cost Outlier Amount.
A4 	Medicare Claim PPS Capital Day Outlier Amount.
99	Medicare Secondary Payer Adjustment Amount.
A3 	Medicare Secondary Payer liability met.
54	Multiple physicians/assistants are not covered in this case .
128	Newborn's services are covered in the mother's Allowance.
93	No Claim level Adjustments.
96	Non-covered charge(s).
78	Non-Covered days/Room charge adjustment.
B1 	Non-covered visits.
111	Not covered unless the provider accepts assignment.
32	Our records indicate that this dependent is not an eligible dependent as defined.
80	Outlier days. (Handled in QTY, QTY01=OU)
120	Patient is covered by a managed care plan.
106	Patient payment option/election not in effect.
A0 	Patient refund amount.
140	Patient/Insured health identification number and name do not match.
124	Payer refund amount - not our patient.
123	Payer refund due to overpayment.
112	Payment adjusted as not furnished directly to the patient and/or not documented.
115	Payment adjusted as procedure postponed or canceled.
B16 	Payment adjusted because `New Patient' qualifications were not met.
23	Payment adjusted because charges have been paid by another payer.
B5 	Payment adjusted because coverage/program guidelines were not met or were exceeded.
B20 	Payment adjusted because procedure/service was partially or fully furnished by another provider.
108	Payment adjusted because rent/purchase guidelines were not met.
17	Payment adjusted because requested information was not provided or was insufficient/incomplete. Additional information is supplied using the remittance advice remarks codes whenever appropriate.
30	Payment adjusted because the patient has not met the required eligibility, spend down, waiting, or residency requirements.
154	Payment adjusted because the payer deems the information submitted does not support this day's supply.
153	Payment adjusted because the payer deems the information submitted does not support this dosage.
152	Payment adjusted because the payer deems the information submitted does not support this length of service.
150	Payment adjusted because the payer deems the information submitted does not support this level of service.
151	Payment adjusted because the payer deems the information submitted does not support this many services.
15	Payment adjusted because the submitted authorization number is missing, invalid, or does not apply to the billed services or provider.
22	Payment adjusted because this care may be covered by another payer per coordination of benefits.
B15 	Payment adjusted because this procedure/service is not paid separately.
B17 	Payment adjusted because this service was not prescribed by a physician, not prescribed prior to delivery, the prescription is incomplete, or the prescription is not current.
117	Payment adjusted because transportation is only covered to the closest facility that can provide the necessary care.
58	Payment adjusted because treatment was deemed by the payer to have been rendered in an inappropriate or invalid place of service.
125	Payment adjusted due to a submission/billing error(s). Additional information is supplied using the remittance advice remarks codes whenever appropriate.
129	Payment denied - Prior processing information appears incorrect.
B14 	Payment denied because only one visit or consultation per physician per day is covered.
113	Payment denied because service/procedure was provided outside the United States or as a result of war.
146	Payment denied because the diagnosis was invalid for the date(s) of service reported.
B18 	Payment denied because this procedure code/modifier was invalid on the date of service or claim submission.
B23 	Payment denied because this provider has failed an aspect of a proficiency testing program.
116	Payment denied. The advance indemnification notice signed by the patient did not comply with requirements.
25	Payment denied. Your Stop loss deductible has not been met.
160	Payment denied/reduced because injury/illness was the result of an activity that is a benefit exclusion.
157	Payment denied/reduced because service/procedure was provided as a result of an act of war.
57	Payment denied/reduced because the payer deems the information submitted does not support this level of service, this many services, this length of service, this dosage, or this day's supply.
159	Payment denied/reduced because the service/procedure was provided as a result of terrorism.
158	Payment denied/reduced because the service/procedure was provided outside of the United States.
62	Payment denied/reduced for absence of, or exceeded, pre-certification/authorization.
24	Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan.
97	Payment is included in the allowance for another service/procedure.
100	Payment made to patient/insured/responsible party.
137	Payment/Reduction for Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.
82	PIP days.
143	Portion of payment deferred.
132	Prearranged demonstration project adjustment.
101	Predetermination: anticipated payment upon completion of services or claim adjudication.
145	Premium payment withholding
A7 	Presumptive Payment Adjustment
B13 	Previously paid. Payment for this claim/service may have been provided in a previous payment.
71	Primary Payer amount.
A6 	Prior hospitalization or 30 day transfer requirement not met.
65	Procedure code was incorrect. This payment reflects the correct code.
114	Procedure/product not approved by the Food and Drug Administration.
94	Processed in Excess of charges.
89	Professional fees removed from charges.
44	Prompt-pay discount.
147	Provider contracted/negotiated rate expired or not on file.
161	Provider performance bonus
103	Provider promotional discount (e.g., Senior citizen discount).
122	Psychiatric reduction.
53	Services by an immediate relative or a member of the same household are not covered.
39	Services denied at the time authorization/pre-certification was requested.
B9 	Services not covered because the patient is enrolled in a Hospice.
B12 	Services not documented in patients' medical records.
38	Services not provided or authorized by designated (network/primary care) providers.
162	State-mandated Requirement for Property and Casualty, see Claim Payment Remarks Code for specific explanation.
86	Statutory Adjustment.
105	Tax withholding.
134	Technical fees removed from charges.
B21 	The charges were reduced because the service/care was partially furnished by another physician.
B11 	The claim/service has been transferred to the proper payer/processor for processing. Claim/service not covered by this payer/processor.
14	The date of birth follows the date of service.
13	The date of death precedes the date of service.
9	The diagnosis is inconsistent with the patient's age.
10	The diagnosis is inconsistent with the patient's gender.
11	The diagnosis is inconsistent with the procedure.
12	The diagnosis is inconsistent with the provider type.
133	The disposition of this claim/service is pending further review.
98	The hospital must file the Medicare claim for this inpatient non-physician service.
4	The procedure code is inconsistent with the modifier used or a required modifier is missing.
8	The procedure code is inconsistent with the provider type/specialty (taxonomy).
5	The procedure code/bill type is inconsistent with the place of service.
6	The procedure/revenue code is inconsistent with the patient's age.
7	The procedure/revenue code is inconsistent with the patient's gender.
52	The referring/prescribing/rendering provider is not eligible to refer/prescribe/order/perform the service billed.
29	The time limit for filing has expired.
51	These are non-covered services because this is a pre-existing condition
49	These are non-covered services because this is a routine exam or screening procedure done in conjunction with a routine exam.
50	These are non-covered services because this is not deemed a `medical necessity' by the payer.
47	This (these) diagnosis(es) is (are) not covered, missing, or are invalid.
48	This (these) procedure(s) is (are) not covered.
46	This (these) service(s) is (are) not covered.
155	This claim is denied because the patient refused the service/procedure.
B22 	This payment is adjusted based on the diagnosis.
B6 	This payment is adjusted when performed/billed by this type of provider, by this type of provider in this type of facility, or by a provider of this specialty.
B7 	This provider was not certified/eligible to be paid for this procedure/service on this date of service.
83	Total visits.
87	Transfer amount.
W1 	Workers Compensation State Fee Schedule Adjustment