Step-by-step fix guides for the most common claim denial codes. Each page covers what the code means, why you received it, how to fix it, and how to prevent it from happening again. Need instant lookup? Try our Denial Code Search Tool.
Claim lacks required data for adjudication. Usually a missing modifier, NPI, or diagnosis pointer.
View fix guide →Payer flagged this as a duplicate of a previously submitted claim or service.
View fix guide →The CPT/HCPCS code is not valid for the date of service or doesn't match the diagnosis.
View fix guide →Billed amount exceeds the contracted rate. Technical fees or negotiated adjustments applied.
View fix guide →The patient's health identification number doesn't match the name on file with the payer.
View fix guide →The provider is not credentialed, enrolled, or authorized to bill for this service.
View fix guide →The National Provider Identifier on the claim doesn't match the payer's records.
View fix guide →The National Provider Identifier is missing, incomplete, or in an invalid format.
View fix guide →The NPI was submitted in an incorrect format. Check digit calculation or length error.
View fix guide →We're adding new denial code guides every week. Need help with a code not listed here? Use our instant lookup tool or contact us for a free denial analysis.
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