Remittance Advice Details (RAD)remit cd500
Codes and Messages: 500 – 5991
Code/Message500 – 510
500Fiscal Intermediaryinitiated – retroactive rate correction.
501Adjustment due to State Controller’s audit.
502Fiscal Intermediaryinitiated – adjustment as a result of a prior overpayment.
503Fiscal Intermediaryinitiated – adjustment as a result of a prior underpayment.
504Fiscal Intermediaryinitiated – adjustment due to a change in the claim date of service.
505Fiscal Intermediaryinitiated – adjustment as a result of a change in the drug/service code.
506Fiscal Intermediaryinitiated – adjustment as a result of 80 percent cutback overpayment.
507Fiscal Intermediaryinitiated void – claim paid under non-contract provider number. Please submit a new claim with contract provider number.
508Fiscal Intermediaryinitiated – adjustment for payment made for wrong recipient and the right recipient is not eligible.
509Adjustment due to an inappropriate payment made for a service rendered on a denied acute (inpatient) day.
510Fiscal Intermediaryinitiated – adjustment as a result of a change in the quantity/number of occurrences per drug/service code.
1 – RAD Codes and Messages: 500 – 599
October2011
Remittance Advice Details (RAD)remit cd500
Codes and Messages: 500 – 5991
511 – 521Code/Message
511Fiscal Intermediaryinitiated – adjustment as a result of a change in the number of estimated days supplied/number of days authorized.
512Fiscal Intermediaryinitiated – adjustment as a result of a change in the recipient’s other coverage.
513Fiscal Intermediaryinitiated – adjustment as a result of a change in the provider’s eligibility status.
514Fiscal Intermediaryinitiated – adjustment as a result of a change in the recipient’s eligibility status.
515Fiscal Intermediaryinitiated – adjustment as a result of a change in the attending, referring, or prescribing provider number.
516Fiscal Intermediaryinitiated – adjustment as a result of a change in the accommodation code.
517Fiscal Intermediaryinitiated – adjustment as a result of a change in the patient’s status code when it was not previously appropriate for the accommodation code.
518Fiscal Intermediaryinitiated – adjustment as a result of a change in the diagnosis code.
519Fiscal Intermediaryinitiated – adjustment as a result of a change in the level of care code.
520Fiscal Intermediaryinitiated – adjustment as a result of a claim that was erroneously denied.
521Fiscal Intermediaryinitiated – adjustment as a result of a change in the original claims decision due to the receipt of additional information.
1 – RAD Codes and Messages: 500 – 599
October2011
remit cd500
1
Code/Message522 – 536
522Payment void – wrong provider number.
523Payment void – wrong recipient number.
524Fiscal Intermediaryinitiated – retroactive reprocessing.
525NCCI (National Correct Coding Initiative) void of a column 2 claim previously paid when a column 1 claim has been processed for the same provider and date of service.
526Provider personal check adjusted.
528Adjustment due to returned provider check.
530State initiated – retroactive rate correction.
531State initiated – inadvertently paid to the wrong provider.
532State initiated – adjustment as a result of a prior overpayment.
533State initiated – adjustment as a result of a prior underpayment.
534State initiated – adjustment as a result of a change in the claim Date of Service.
535State initiated – adjustment as a result of a change in the claim drug/service code.
536State initiated void as a result of thru date of service overlapping the CMSP contract effective date. This claim must be split-billed, resubmit.
1 – RAD Codes and Messages: 500 – 599
October2011
EOB/RA CODES AND MESSAGES
585 – 599
CodeMessage
537 – 547Code/Message
537State initiated void. Claim paid under non-contract provider number. Please submit a new claim with contract provider number.
538State initiated – adjustment for payment made for wrong recipient and the right recipient is not eligible.
539State initiated – adjustment as a result of an appeal.
540State initiated – adjustment as a result of a change in the quantity/number of occurrences per drug/service code.
541State initiated – adjustment as a result of a change in the number of estimated days supplied/number of days authorized.
542State initiated – adjustment due to a change in the recipient’s other coverage.
543State initiated – adjustment as a result of a change in the provider’s eligibility status.
544State initiated – adjustment as a result of a change in the recipient’s eligibility status.
545State initiated – adjustment as a result of a change in the attending, prescribing, or referring provider number.
546State initiated – adjustment as a result of a change in the accommodation code.
547State initiated – adjustment as a result of a change in the patient’s status code when it was not previously appropriate for the accommodation code.
1 – RAD Codes and Messages: 500 – 599
October2011
remit cd500
1
Code/Message548 – 562
548State initiated – adjustment as a result of a change in the diagnosis code.
549State initiated – adjustment as a result of a change in the level of care code.
550State initiated void – this service is not a benefit of Medi-Cal on the date of service billed.
551State initiated – adjustment as a result of a change in the original claims decision due to the receipt of additional information.
552Payment void – wrong provider number.
553Payment void – wrong recipient number.
554Occidental initiated – Medicare crossover adjustment.
555Blue Shield initiated – Medicare crossover adjustment.
556Adj A/C appeal.
558Ordering/Referring/Prescribing NPI not enrolled or eligible for the service billed on date of service. Future claims may deny.
559ACA Crossover Chip Away Payment Adjustment.
560Fiscal Intermediary initiated – void retro adjustment.
561Fiscal Intermediary initiated – voided retro duplicate CCN.
562Fiscal Intermediary initiated – retroactive reprocessing.
1 – RAD Codes and Messages: 500 – 599
June 2017
remit cd500
1
563 – 579Code/Message
563Retroactive reprocessing.
564Voided APR-DRG interim claim.
565Fiscal Intermediary initiated – crossover reprocessing.
566APR-DRG (All Patient Refined Diagnosis Related Groups) – Claim voided due to corresponding split claim denial.
567Provider initiated – adjustment as a result of a change in Share of Cost information.
568Ancillary split claim voided due to split claim accommodation code denial.
570Fiscal Intermediary initiated – recoupment if paid services provided during PSRO denied hospitalization days.
571Adjustment due to State Controller’s audit.
572Provider initiated – adjustment as a result of an overpayment.
573Provider initiated – adjustment as a result of an underpayment.
574Provider initiated – adjustment as a result of a change in the claim date of service.
575Provider initiated – adjustment as a result of a change in the drug/service code.
578Adjustment due to CCS audit.
579Adjustment due to CHDP audit.
1 – RAD Codes and Messages: 500 – 599
June 2017
remit cd500
1
Code/Message580 – 590
580Provider initiated – adjustment as a result of a change in the quantity/number of occurrences per drug/service code.
581Provider initiated – adjustment as a result of a change in the number of estimated days supplied/number of days authorized.
582Provider initiated – adjustment due to a change in the recipient’s other coverage.
583Provider initiated – adjustment as a result of a change in the provider’s eligibility status.
584Provider initiated – adjustment as a result of a change in the recipient’s eligibility status.
585Provider initiated – adjustment as a result of a change in the attending, prescribing, or referring provider number.
586Provider initiated – adjustment as a result of a change in the Accommodation Code.
587Provider initiated – adjustment as a result of a change in the Patient’s Status Code when it was not previously appropriate for the Accommodation Code.
588Provider initiated – adjustment as a result of a change in the Diagnosis Code.
589Provider initiated – adjustment as a result of a change in the Level of Care Code.
590Provider initiated – adjustment as a result of a claim that was erroneously denied.
1 – RAD Codes and Messages: 500 – 599
September 1999
remit cd500
1
591 – 599Code/Message
591Provider initiated – adjustment as a result of a change in the original claims decision due to the receipt of additional information.
592Payment void – wrong provider number.
593Payment void – wrong recipient number.
594Occidental initiated – Medicare crossover adjustment.
595Blue Shield initiated – Medicare crossover adjustment.
596Blue Shield initiated – Medicare crossover void.
597Occidental initiated – Medicare crossover void.
598Fiscal Intermediaryinitiated – adjustment as a result of an incorrect payment associated with a returned warrant which has been redeposited by the State.
599Fiscal Intermediaryinitiated – adjustment as a result of an over or underpayment associated with a returned warrant which has been redeposited by the State.
1 – RAD Codes and Messages: 500 – 599
September 1999