Code:

Description:

R01

RETURN TO PROVIDER -- Employer Group not effective for this date of service

R02

RETURN TO PROVIDER -- Employer Group terminated prior to date of service

R03

RETURN TO PROVIDER -- Employer Group runout date has been passed

R04

Insured not valid for this date of service for the group listed

R05

Patient not valid for this date of service for the group listed

R06

At Payor's request: Re-submit claim directly to payor

R10

Payer requires Provider Name or Signature in Box 31

R19

RETURN TO PROVIDER -- Invalid CPT Code

R20

Provider not active for this date of service

R21

Provider ineligible for this Employer Group for this date of service

R23

Employer Group excluded from using providers in this City

R24

Employer Group excluded from using providers in this County

R25

Employer Group excluded from using providers in this Region

R26

Employer Group excluded from using providers in this State

R27

Provider is excluded for this Administrator

R28

PPO is excluded for this Administrator

R29

PPO is excluded in this City

R30

PPO is excluded in this County

R31

PPO is excluded in this Region

R32

PPO is excluded in this State

R34

Employer Group excluded from using this PPO

R35

Employer Group only allowed to use Hospital providers

R36

Employer Group excluded from using providers in this EPO

DUP

Duplicate line item from previously repriced claim

NPR

Non Par Provider

SUB

Submitted charges less than or equal to negotiated amount