Fertility services covered by network EXC_Natpath Documentation code(s) >$0 Taxonomy code 246Z00000X maxTimes1 AA off for BR that goes to audit Newborn: no outreach done High Importance note from 2016 Dependent not found Dual coverage requiring override EXC_Tattoo Gap exception requiring override Newborn: outreach done, pend Requires per diem pricing Benefit Amount >$500k Medical student taxonomy code EXC_MN_ModSG Lesser-of requiring override Override to Bariatric Surgery benefit Benefit amount >$100k, <$500 Vague revenue code NOT 761 or 940 Strapping code(s) billed with PT benefit Override to member's cost- sharing Third adjustment Fertility services covered by network EXC_Natpath Documentation code(s) >$0 Taxonomy code 246Z00000X maxTimes1 AA off for BR that goes to audit Newborn: no outreach done High Importance note from 2016 Dependent not found Dual coverage requiring override EXC_Tattoo Gap exception requiring override Newborn: outreach done, pend Requires per diem pricing Benefit Amount >$500k Medical student taxonomy code EXC_MN_ModSG Lesser-of requiring override Override to Bariatric Surgery benefit Benefit amount >$100k, <$500 Vague revenue code NOT 761 or 940 Strapping code(s) billed with PT benefit Override to member's cost- sharing Third adjustment
(Print)
Fertility services covered by network
EXC_Natpath
Documentation code(s) >$0
Taxonomy code 246Z00000X
maxTimes1
AA off for BR that goes to audit
Newborn: no outreach done
High Importance note from 2016
Dependent not found
Dual coverage requiring override
EXC_Tattoo
Gap exception requiring override
Newborn: outreach done, pend
Requires per diem pricing
Benefit Amount >$500k
Medical student taxonomy code
EXC_MN_ModSG
Lesser-of requiring override
Override to Bariatric Surgery benefit
Benefit amount >$100k, <$500
Vague revenue code NOT 761 or 940
Strapping code(s) billed with PT benefit
Override to member's cost-sharing
Third adjustment
