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to non-Acela Business class, First class or sleeping accommodation. N83 No appeal rights. Note: (Modified 2/1/04) M40 Claim must be assigned and must be filed by the practitioner's employer. If treatment has been discontinued, please contact Customer Service. Apply to that facility for payment, or resubmit your claim if: the facility notifies you the patient was excluded from this demonstration; or if you furnished these services in another location on the date of the patients admission or discharge from a demonstration hospital. Timely Claim Filing.

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Note: (Modified 2/28/03, 6/30/03) M130 Missing invoice or statement certifying the actual cost of the lens, less discounts, and/or the type of intraocular lens used. 5 The procedure code/bill type is inconsistent with the place of service. Note: (New Code 12/2/04) N291 Missing/incomplete/invalid rending provider secondary identifier. 12 The diagnosis is inconsistent with the provider type. N87 Home use of biofeedback therapy is not covered. Note: (Modified 2/28/03) N77 Missing/incomplete/invalid designated provider number. Note: Changed as of 2/01 117 Payment adjusted because transportation is only covered to the closest facility that can provide the necessary care. N62 Inpatient admission spans multiple rate periods.

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