Reason Code 5H164: Documentation Does Not Support Medical Necessity
This claim was fully or partially denied because the documentation submitted for review does not support the medical necessity of some of the services billed.
To Prevent This Denial
- Submit all documentation related to the services billed which support the medical necessity of the services
- A legible signature is required on all documentation necessary to support orders and medical necessity
- Use the most appropriate ICD-10-CM codes to identify the beneficiary’s medical diagnosis