Reason Code Help Tool
Disclaimer: This lookup tool does not contain all reason codes found in the Direct Data Entry (DDE) Reason Code file. Please refer to Section 5: Claims Corrections (PDF) of the DDE Guide for additional information.
Reason codes may be added and are subject to change based on quarterly claim submission error data analysis.
This Reason Code Help Tool is designed to aid you in reviewing, understanding, and resolving the most frequent reason codes, or for determining if other actions are needed. You may search the tool by reason code, keyword or phrase. All records matching your search criteria will be returned for your review. You may also use the “Show All” button to view a complete list of reason codes available.
Questions pertaining to individual claims must be directed to the Provider Contact Center. You may fax a Written Inquiry Request form (PDF) to have your inquiry answered. Please do not include any Protected Health Information.