Every denial code, and whether it's worth fighting.

These services are not deemed a medical necessity by the payer.

This (these) diagnosis(es) is (are) not covered.

The payer decided the care was not emergent or urgent.

Documentation does not support the level of service billed.

The duration billed is not supported by the documentation.

The dosage billed is not supported by the documentation.

The days supply billed is not supported by the record.

The payer treats the procedure as unproven for this condition.

Payment reduced for a missing second surgical opinion.

Precertification / authorization / notification absent.

Authorization number is missing, invalid, or doesn't match.

The service was refused when authorization was requested.

Required pre-certification or notification was not obtained.

A required referral was not on file for the visit.

A plan process requirement was not followed.

The service exceeded the authorized quantity.

Units billed exceed a contractual maximum for the provider.

An authorization exists but does not cover the services billed.

Care exceeded the visits or amount the referral authorized.

The authorization names a different provider than the one who billed.

The authorization expired before the service was delivered.

The benefit for this service is included in another service already paid (NCCI).

Processed based on multiple- or concurrent-procedure rules.

This procedure is not paid separately (bundled).

Two procedures billed together are treated as mutually exclusive.

Payment reduced because a component was already paid.

The service was already paid as part of another service.

Procedure code is inconsistent with the modifier — or a required one is missing.

The diagnosis is inconsistent with the procedure.

Procedure/revenue code is inconsistent with the patient's age.

A gender edit rejected the procedure billed.

An age edit rejected the diagnosis submitted.

A gender edit rejected the diagnosis submitted.

The diagnosis code was not valid on the date of service.

A neonatal edit compared the diagnosis against birth weight.

The procedure conflicts with the patient history the payer holds.

The procedure and the place-of-service code do not match.

The procedure code was not valid on the date of service.

The modifier was not valid on the date of service.

The modifier cannot be used with the procedure billed.

The revenue code and procedure code do not correspond.

Documentation doesn't support this many / this frequency of services.

Charge exceeds the fee schedule / contracted allowed amount.

The payer processed an amount in excess of the charges billed.

A discount negotiated for this specific claim was applied.

A statutory sequestration reduction in federal payment.

The excess over the allowed amount, assigned to the patient.

Service/equipment/drug not covered under the patient's current benefit plan.

Non-covered charge under the patient's plan.

A benefit maximum for this service has been reached.

Service not covered under the patient's current benefit plan.

The payer classes the service as experimental or investigational.

The payer says the item lacks FDA approval for this use.

Coverage is limited to the FDA-recommended use.

The service was treated as a routine exam or screening.

Care excluded as related to a pre-existing condition.

The service falls under a written benefit exclusion.

The item was classed as personal comfort or convenience.

The service is not payable under the managed care arrangement.

A lifetime benefit maximum has been reached.

A lifetime maximum for this benefit category has been reached.

A non-covered charge, assigned to the patient.

Claim/service not covered by this payer or contractor — send it elsewhere.

Expenses incurred after the patient's coverage had terminated.

The payer cannot match the patient to a member record.

An identity mismatch, with the balance assigned to the patient.

The service predates the coverage effective date.

A plan eligibility condition was not satisfied on the service date.

The service fell in a gap between coverage periods.

This care may be covered by another payer per coordination of benefits.

Service is covered under a capitation agreement / managed care plan.

Work-related injury — workers' compensation carrier is liable.

The payer says a liability carrier is responsible for the injury.

The payer says a no-fault carrier is responsible for the injury.

A secondary adjustment reflecting the primary payer's adjudication.

Prior-payer coordination under an Other Adjustment group code.

The payer believes another plan should pay first.

The claim reached the wrong payer or contractor.

A requirement of the primary payer was not met.

Claim lacks information or has a submission/billing error.

Exact duplicate claim or service.

The time limit for filing this claim has expired.

Patient/insured health ID number and name don't match.

An attachment or additional documentation is required.

The payer's record shows a date of death before the service date.

The date of birth on file falls after the date of service.

A required National Provider Identifier is missing from the claim.

An NPI on the claim fails format or validity checks.

A valid NPI that does not match the payer's enrolment file.

A broad submission or billing error adjustment.

Prior payer information on the claim does not reconcile.

Documentation the payer required was not received.

Documentation arrived but did not contain what was required.

A container adjustment that must carry a remark code.

A late-filed claim, with the balance assigned to the patient.

Payment reduced under a late-filing penalty.

Supporting documentation missed the payer's response window.

Requested provider information was not supplied in time.

The claim or service is flagged as an exact duplicate.

Provider was not certified/eligible to be paid for this service on this date.

The provider was not certified or eligible on the date of service.

The payer does not associate this procedure with the provider's specialty.

No contracted rate is loaded for the provider or service.

The plan does not pay this provider type for this service.

The provider type is not payable in this facility setting.

Payment adjusted because of the provider's specialty on file.

The referring provider is not eligible to refer for this service.

The ordering or prescribing provider is not eligible.

The rendering provider is not eligible to perform this service.

Deductible amount — the patient's cost share, not a denial.

Coinsurance amount — the patient's cost share, not a denial.

Co-payment amount — the patient's fixed cost share, not a denial.

A pre-coverage service, with the balance assigned to the patient.

Coverage ended before the service; balance assigned to the patient.

An unmet eligibility condition, charged to the patient.

A blood deductible applied to the first units in a year.

An interest amount attributed to the patient.

Liability assigned under a set-aside arrangement.

A partial charge is not permitted for this bill type.

Payment reduced for the ineligible part of a date span.

The reduced copay for a member with a low-income subsidy.

A deductible on the professional service in a facility setting.

Coinsurance on the professional service in a facility setting.

The secondary will not cover the primary's patient responsibility.