Missing independent medical exam detailing the cause of injuries sustained and medical necessity of services rendered. This degree of sophistication ensures that as much light as possible is transmitted through the optics which results in super bright contrast rich images of high colour fidelity for the user even in low light conditions where less expensive optics and coatings result in a dramatic loss of performance. For the comfort of the user the binoculars are supplied with metal twist up eyecups that are rubber coated which make them equally practical for people to use with or without spectacles. The rapid focus mechanism takes the user from close focus to infinity in less than one turn of the focus control knob, which ensures that you can follow the action however fast it is happening. Medicare Part B does not pay for items or services provided by this type of practitioner for beneficiaries in a Medicare Part A covered Skilled Nursing Facility (SNF) stay. Your unassigned claim for a drug or biological, clinical diagnostic laboratory services or ambulance service was processed as an assigned claim. You are required by law to accept assignment for these types of claims. The services billed are considered Not Covered or Non-Covered (NC) in the applicable state fee schedule.

Alert: This procedure code was added/changed because it more accurately describes the services rendered. Medical provider not authorized/certified to provide treatment to injured workers in this jurisdiction. Information from another provider was not provided or was insufficient/incomplete. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Alert: Our records do not indicate that other insurance is on file. Please submit other insurance information for our records. Claim/service denied because information to indicate if the patient owns the equipment that requires the part or supply was missing.

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This procedure or procedure/modifier combination is not compatible with another procedure or procedure/modifier combination provided on the same day according to the National Correct Coding Initiative or workers compensation state regulations/ fee schedule requirements. Service not paid under jurisdiction allowed outpatient facility fee schedule. To be used for Property and Casualty only. Alert: You may be subject to penalties if you bill the patient for amounts not reported with the PR (patient responsibility) group code. If you come within either exception, or if you believe the carrier was wrong in its determination that we do not pay for this service, you should request appeal of this determination within 30 days of the date of this notice. Your request for review should include any additional information necessary to support your position.

A not otherwise classified or unlisted procedure code(s) was billed but a narrative description of the procedure was not entered on the claim. Refer to item 19 on the HCFA-1500. This procedure is not paid separately. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)

Policies and Procedures

An attachment/other documentation is required to adjudicate this claim/service. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT). The patient is not liable for the denied/adjusted charge(s) for receiving any updated service/item. Decision based on review of previously adjudicated claims or for claims in process for the same/similar type of services.