Wiki Claim adjustment reason codes -> B15 Denial Code

[coe_angela@hotmail.com]

Hi there-

Can anyone point me in the direction of how to decipher which group codes are applicable to which denial codes?

My question specifically is regarding the B15 denial code. How do I know which Group Code this may (or may not) fall under?

Some of the denial codes easily identify that they only can be used with one Group Code - for example denial code 23 states it can only be used with Group Code OA. Denial code B15 does not clarify this.

I'm trying to make sure our PM system is set up accurately for our posters to be able to capture denial code reasons.

Thank you!!

 

[Walker22]

Denial codes that have no specific group code mentioned will most likely be used in several or all of the group codes depending on the circumstances of that claim. Also, just because 23 states it can only be used with OA doesn't mean that some payers won't try to use it with another group. I've seen that happen before.

 

[coe_angela@hotmail.com]

Thanks Walker!