5 Most Common Reason for Denials in Surgery Centers

Here are the top five most common reason codes by denial count for unexpected denials, from highest to lowest. The data is based on 25 percent of all national outpatient remittances from of September, according to RemitDATA. RemitDATA is an independent, leading source of comparative analytics for reimbursement, utilization and productivity data.

Code 18: Duplicate claim/service.

Code 16: Claim/service lacks information which is needed for adjudication. At least one Remark Code must be provided

Code 97: The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.

Code 22: This care may be covered by another payer per coordination of benefits.

Code 96: Non-covered charge(s). At least one Remark Code must be provided

Learn more about RemitDATA.

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