Which denial codes appear with MA63?

MA63 commonly rides with CO 16, CO 11, CO 146. The adjustment code says the claim was reduced; the remark code says why.

Remark code

MA63 denial code

The principal diagnosis is missing, not coded to full specificity, or not valid on the date of service.

A correction, not an appeal

A remark code is not the denial. The adjustment code says the claim was reduced. This one says why. You need both to know what to send back.

What to do

Check the first-listed diagnosis. It has to be coded to the highest level of specificity, valid on the date of service, and a code that is allowed to be listed first. Correct it from the record and resubmit. This is a correction, not an appeal.

Codes it appears with

MA63 commonly rides alongside these. Our reading, not a published mapping: X12 publishes no adjustment-to-remark table.

Code	What that one means
CO 16	Something the payer needed was missing or wrong on the claim.
CO 11	The diagnosis does not match the procedure billed.
CO 146	The diagnosis was not valid on that date of service.

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