Control Number OH 027 78 Form
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People also ask
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What is the denial code for exceeds max allowable?
To wrap this all up, what does denial code CO-45 mean? CO-45 marks a fee that exceeds the maximum allowable amount for a service charge. Or when those charges exceed a contracted fee arrangement. This adjustment amount cannot equal the total service or claim charge amount.
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What is denial 45 exceeds max allowable?
Denial code CO 45 is one of the most common denial codes insurance companies use. It is “Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.” In simpler terms, it means that the provider has charged more than what is allowed or agreed upon by the insurance company.
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What does charge exceeds fee schedule maximum allowable or contracted legislated fee arrangement mean?
Denial code 45 is used when the charge for a service exceeds the fee schedule, maximum allowable amount, or the contracted/legislated fee arrangement. This means that the amount being charged for the service is higher than what is allowed or agreed upon by the payer.
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What number on the CMS-1500 form is the ICD-10 CM code reported?
Additionally, the CR provides instruction for processing claims where an ICD-10-CM diagnosis code within the code range of V00 through Y99 is reported as the first diagnosis of the claim in Item 21 of the Form CMS-1500, when ICD-10-CM diagnosis codes are effective.
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What is service line number greater than maximum allowable for payer?
Code description: Service line number greater than maximum allowable by payer. What this code means:You've billed more services on one line than allowed by the payer. Actions you should take: The payer may reduce payment to the maximum, or you may have to resubmit a corrected claim or appeal.
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What is denial code c094?
What is Denial Code 94. Denial code 94 means that the claim has been processed for an amount that exceeds the charges submitted. In other words, the insurance company has determined that the billed amount is higher than what they consider to be reasonable or appropriate for the services provided.
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