109 N418 05D Benefits for this service have a twelve-month waiting period These expenses are not eligible since there is no money left in your Flexible Spending Account(FSA) This is a not a covered service under medical benefits. 59 N Services denied due to being delegated to another entity. B5 N This charge exceeds the maximum allowable under this member's coverage. B5 N640 04D Benefits for this service are limited to one time per thirty-six month period. B5 N640 03D Benefits for this service are limited to one time per three-month period. Benefits were extended by our Utilization Management department This charge exceeds the maximum allowable under this member's coverage 45 01D Processing of this claim was suspended awaiting information requested from this provider or subscriber D Benefits for this service are limited to two times per contract year. Standardized descriptions for the HIPAA adjustment reason and remark codes can be accessed on the Washington Publishing Company Web site at EXCD_ID Text CARC RARC 002 This charge exceeds the maximum allowable under this member's coverage This service is limited by the member's plan. Where appropriate, we have included the HIPAA-compliant remark and/or adjustment reason code that corresponds to a BlueCross BlueShield of Tennessee explanation code. The electronic remittance advice (ANSI-835) uses HIPAA-compliant remark and adjustment reason codes.
HIPAA-compliant electronic remittance advice (ANSI-835) will not use these explanation codes. These same codes and descriptions will also apply to online Commercial remittance advices, available on BlueAccess, the secure area of Although the provider action/information column does not appear on the remittance advice, we have included it on this document to assist you. 1 1 Commercial Remittance Advice Code Descriptions Effective for remittance advices that reflect dates of service of May 1, 2008, and after, explanation codes used for the BlueCare and TennCareSelect lines of business will also appear in this listing The following remittance explanation codes and descriptions reflect those found on hardcopy (paper) Commercial remittance advice.
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