Edit 00291

Recipient Ineligible (Coverage Code is Equal to 02)

HIPAA Claim Adjustment Reason Code: 16
    Remark Code: N30
HIPAA Healthcare Claim Status Code: 109
    Entity Identifier Code: QC

Potential Causes:
The eligibility for the patient is for Outpatient Services only. The claim submitted does not fall into that category.

Solution:
Contact the Department of Social Services regarding the eligibility coverage of the patient.