Denial Resolution

Published 6/1/2016

The Palmetto GBA Denial Resolution tool includes resources for resolving the top claim rejections and denial reasons. Save time and resources by looking here before you pick up the phone.

  • Access denial reasons in plain language
  • Scroll through the titles to locate your procedure
  • Use the Palmetto GBA search engine to search by remark code

Eye Refraction: Statutory DenialsEKG, EKG Rhythm Strip and Cardiac Echography: NCCI Bundling DenialsE/M Services: CCI Bundling DenialsX-Rays: Denied for ChiropractorsHospice: Non-Attending Physician DenialsCode/Modifier Combination Invalid and Modifier Invalid/MissingDuplicate Denials: Compliance MattersChest X-ray or EKG: Duplicate DenialsGlycosylated Hemoglobin A1C: Medical Necessity DenialsVenipuncture: Not Covered by This Payer (Facility Setting)Clinical Laboratory Procedures: Duplicate DenialsVenipuncture: Statutory DenialsElectronic Claim Required: DenialsDiagnostic Cardiology Services: Medical Necessity DenialsE/M Service: Global Surgery DenialsAnesthesia Services: Bundling DenialsNCCI Bundling DenialsEstablished Patient Office Visits: NCCI Bundling DenialsNPI: Troubleshooting RejectionsHot or Cold Packs: Bundling DenialsReason Code CO-96: Non-covered ChargesCLIA: Laboratory TestsUnlisted Supplies: Bundling DenialsProvider Certification DenialsSkilled Nursing Facility: Not Covered by This Payer (Consolidated Billing Denials)E/M Service: Duplicate DenialsCLIA Certification Number RequiredChiropractic Manipulative Treatment DenialsSubmitted to Incorrect Program: 'Jurisdiction' DenialsLipid Panels: Medical Necessity DenialsElectronic Claim Required: DenialsTop Reasons for Claim Denials and RejectionsRoutine Physical Exams: Statutory DenialsMSP: Eligibility & DenialsCARC 181CARC 50Physical & Occupational Therapy and Speech Language Pathology Caps: Financial Limitation Denials