Medicare denial code N347,N449,N522 & MA04 description

Denial reason code MA04 Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible.


Resubmit with primary EOB

MA04 means that the claim was submitted with an invalid Medicare Secondary Payer (MSP) code or an MSP code was not included. When this happens, check to ensure the information is correct in loop 2320 for an electronic claim or attach the summary notice from the primary insurer that specifically corresponds to the claim you are submitting for paper claims. Once the information is corrected, resubmit the claim to Railroad Medicare

CO -18, 22 denail codes and related remark codes 

Adj. Reason Code	Adj. Reason Code Description	Remark Code	Remark Code Descripton	Exception Code Descripton
18	Duplicate claim/service.	N347	Your claim for a referred or puchased service cannot be paid because payment has already been made for this same service	EXACT DUP OR MANUAL PRICE
18	Duplicate claim/service.	N449	Payment based on a comparable drug/service/ supply.	DRUG/CHEMICAL DUPLICATION NOT ALLOWED
18	Duplicate claim/service.	N522	Duplicate of a claim processed, or to be processed, as a crossover claim.	MEDICAID/MEDICARE EXACT DUP
18	Duplicate claim/service.			POSSIBLE DUP DENTAL EXTRACT
				EXACT DUP OF PAID CLAIM
				ICF EXACT DUPLICATE
				ICF POSSIBLE CLAIM CONFLICT
				SURGICAL SESSION - TWO CLAIMS
				LTC EXACT DUP CLAIM THIS CYCLE
				EXACT DUP WITH PAID CLAIM
				SAME/OVRLP DOS THIS CYCLE INPT
				EXACT DUP CLAIM THIS CYCLE
				DUPLICATE PYMT - CS MNGMNT FEE
				DUPLICATE PAID/CAPTURED CLAIM
				CLAIM NOT PAID/CAPTURED
				CCE EXACT DUPE CLAIM THIS CYCLE
				DUPLICATE PROCEDURE EXCEEDS UNIT LIMIT
				DUP/CONFLICTING SURFACE
22	This care may be covered by another payer per coordination of benefits.	MA04	Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible.	RECIP HAS MEDICAL INSURANCE
				MEDICARE ELIG-NO ATTCHMT
				MEDICARE WITHIN DATE(S) OF SVC
				RR TRAVELERS MEDICARE WITHIN DOS
				MEDICARE COVERED DOS OVERLAP
				RR TRAVELERS MEDICARE & DOS OVERLAP
				RECIP HAS TPL-CLM W/ATTACHMENT
				DENTAL-CLAIM HAS ATTACHMENT
				CLAIM HAS ATTACHMENT
22	This care may be covered by another payer per coordination of benefits.	MA64	Our records indicate that we should be the third payer for this claim. We cannot process this claim until we have received payment information from the primary and secondary payers.	MEDICARE DOS OVERLAP TPL
				RR MDCRE/TPL OVERLAP
22	This care may be covered by another payer per coordination of benefits.	MA92	Missing plan information for other insurance.	RECIP HAS MEDICAL INSURANCE
22	This care may be covered by another payer per coordination of benefits.			MENTL HLTH XOVR CLM NON-QMB CLIENT
				QMB - SEND BILL TO MEDICARE
				CROSSOVER SERVICE ONLY
				PATIENT TRANSFERED TO MEDICARE
				AMOUNT BILLED LESS THAN MINIM
				DENTAL BILL AMT LESS THAN MIN
				TPL BILLED LESS THAN MINIMUM
				TPL NOT REPORTED ON CROSSOVER CLAIM
				TPL AMOUNT NOT NUMERIC