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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.
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