Reason Code 55503

Published 12/16/2019

Description 
Service is not medically necessary based on Medicare guidelines. If you disagree with this decision you may ask for a redetermination within the program time frames.

Resolution
Refer to Palmetto GBA's LCDs on our website under Medical Policies for JJ Part A and JM Part A. If you disagree with this decision, you may request a redetermination.


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