What are the OA 11 and OA 13?

What are the OA 11 and OA 13?

OA 11 The diagnosis is inconsistent with the procedure. OA 12 The diagnosis is inconsistent with the provider type. OA 13 The date of death precedes the date of service. OA 14 The date of birth follows the date of service. OA 16 Claim/service lacks information which is needed for adjudication.

What is the difference between OA 206 and OA 208?

OA 199 Revenue code and Procedure code do not match. OA 206 NPI denial – missing: OA 208 NPI denial – not matched: OA 209 Per regulatory or other agreement. The provider cannot collect this amount from the patient. However, this amount may be billed to subsequent payer. Refund to patient if collected. (Use Group code OA)

What does OA 19 and OA 20 mean?

OA 19 Claim denied because this is a work-related injury/illness and thus the liability of the Worker’s Compensation Carrier. OA 20 Claim denied because this injury/illness is covered by the liability carrier.

What are the OA 100 and OA 104?

OA 100 Payment made to patient/insured/responsible party. OA 104 Managed care withholding. OA 105 Tax withholding. OA 106 Patient payment option/election not in effect. OA 109 Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor. OA 116 Payment denied.

What is an OA 136 claim adjustment?

OA 136 Claim adjusted based on failure to follow prior payer’s coverage rules. (Use Group Code OA). OA 137 Payment/Reduction for Regulatory Surcharges, Assessments, Allowances or Health Related Taxes. OA 141 Claim adjustment because the claim spans eligible and ineligible periods of coverage.

What are OA 116 and OA 131?

OA 116 Payment denied. The advance indemnification notice signed by the patient did not comply with requirements. OA 118 Charges reduced for ESRD network support. OA 121 Indemnification adjustment. OA 122 Psychiatric reduction. OA 130 Claim submission fee. OA 131 Claim specific negotiated discount.

What does OA 9 mean in medical terms?

OA 9 The diagnosis is inconsistent with the patient’s age. OA 10 The diagnosis is inconsistent with the patient’s gender. OA 11 The diagnosis is inconsistent with the procedure. OA 12 The diagnosis is inconsistent with the provider type. OA 13 The date of death precedes the date of service. OA 14 The date of birth follows the date of service.