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Reason Code Search and Resolution

Disclaimer: This is not a complete listing of reason codes. Other reason codes will be added.

This Reason Code Search and Resolution tool has been designed to aid Medicare providers in reviewing reason codes and how to resolve the edit or use them for determining if other action is needed. You may search this database by reason code or keyword. All records matching your search criteria will be returned for your review. If you are aware of a reason code not listed or a description and/or a resolution is not clear, please send your suggestion for reason code addition or update to J15_PARTA_Education@cgsadmin.com.

If you wish, you may also view the entire listing of reason codes, their descriptions, resolutions, and additional billing information by clicking on the "Show all Reason Codes" option.

Reason Code 39934

Description:

All line items on the claim are denied as non-covered and one or more lines denote beneficiary liability.

Resolution:

  • Line item denial information can be obtained from the remittance advice or via the Direct Data Entry (DDE) system. Review the reason for denial and verify the information submitted on the claim.
  • Line item denials are usually medical necessity denials. If you disagree, you may request a redetermination (first level of appeal).

References:

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