Results 1 to 7 of 7

Medicare denial/reason codes

  1. #1
    Default Medicare denial/reason codes
    Exam Training Packages
    Has anyone ever encountered OA-121 "Indemnification adjustment - compensation for outstanding member responsibility" on the EOB? Please explain to me what this means....we have never seen it before and thanks ahead!!!!

  2. Default
    We called Medicare and the rep did not know. We faxed her a copy of our remittance and are waiting work back.

  3. Default
    I believe that's the PECOS warning.
    ~Ursula, CPC~

  4. #4
    Kansas City MO
    This is a possible MSP and/or an unbundling adjustment. Example: TPL is primary carrier is primary, then MC pays secondary. The unbundling is pretty self explanatory. In some states, you bill, for instance, auto carrier first and that carrier allows you to bill E&M with other services that MC would usually not allow. MC would disallow it under OA-121. Hope this doesn't confuse you more.

  5. #5
    It didn't confuse me at all and thanks for your input....but..... this patient does not have a secondary and is responsible for the balance. I thought at first it had to do with the ABN for this particular procedure but the patient didn't sign one so it was not that either.....this one just puzzles me!!!

  6. Default
    We contacted MCR they stated it is warning that the rendering or referring provider is not in PECOS and starting 1-4-2010 the claims will be denied.

  7. #7
    Thanks all!!!!

Similar Threads

  1. Claim adjustment reason codes -> B15 Denial Code
    By in forum Billing/Reimbursement
    Replies: 2
    Last Post: 09-14-2015, 01:57 PM
  2. Medicare denial reason 183
    By ivonneatanacio in forum Medicare Regulations
    Replies: 3
    Last Post: 02-13-2014, 09:39 AM
  3. Reason for visit codes
    By Lomakema in forum Emergency Department
    Replies: 3
    Last Post: 10-04-2013, 12:32 PM
  4. post your denial reason questions here
    By LuluBarr in forum Medical Coding General Discussion
    Replies: 4
    Last Post: 07-20-2010, 07:25 AM
  5. Medicare Reason Code 31715
    By pattivest in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 05-05-2008, 01:05 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.