DENIAL CODES

Denial code P29

Denial code P29 is a fee schedule adjustment related to liability benefits. It can be at the claim or line level and requires the payer to send specific information to the provider. This code is applicable to Property and Casualty Auto only.

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What is Denial Code P29

Denial code P29 is related to a jurisdictional fee schedule adjustment for liability benefits. If this denial code is at the claim level, the payer is required to send information regarding the adjustment, and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF). If the denial code is at the line level, the payer must send information related to the adjustment, and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. It is important to note that this denial code is specifically applicable to Property and Casualty Auto cases only.

Common Causes of CARC P29

Common causes of code P29 are:

1. Incorrect jurisdictional fee schedule adjustment: The payer may have made an error in applying the appropriate fee schedule adjustment for the specific jurisdiction. This could result in a denial with code P29.

2. Missing or incomplete 835 Class of Contract Code Identification Segment: If the adjustment is at the claim level, the payer is required to send the 835 Class of Contract Code Identification Segment. If this segment is missing or incomplete, it can lead to a denial with code P29.

3. Missing or incomplete 835 Healthcare Policy Identification Segment: If the adjustment is at the line level, the payer is required to send the 835 Healthcare Policy Identification Segment if the regulations apply. If this segment is missing or incomplete, it can result in a denial with code P29.

4. Non-compliance with regulations for Property and Casualty Auto: Code P29 is specifically applicable to Property and Casualty Auto claims. If the claim does not meet the specific regulations for this type of claim, it can lead to a denial with code P29.

It is important for healthcare providers to review and ensure the accuracy of fee schedule adjustments, as well as the presence and completeness of the required segments in the 835 transaction, to avoid denials with code P29.

Ways to Mitigate Denial Code P29

Ways to mitigate code P29 include:

1. Ensure accurate and up-to-date jurisdictional fee schedules: Regularly review and update jurisdictional fee schedules to ensure that they align with the current regulations and guidelines. This will help prevent any discrepancies or adjustments that may trigger code P29.

2. Implement robust claims management processes: Establish efficient claims management processes that include thorough verification and validation of claims before submission. This will help identify any potential issues or discrepancies that may lead to code P29 and allow for timely resolution.

3. Utilize electronic data interchange (EDI) capabilities: Leverage EDI capabilities to electronically transmit claims and receive remittance advice from payers. This will help streamline the claims submission and payment process, reducing the chances of errors or adjustments that may result in code P29.

4. Stay informed about healthcare policies and regulations: Regularly stay updated with the latest healthcare policies and regulations, especially those related to liability benefits and property and casualty auto claims. This will enable you to proactively address any changes or requirements, minimizing the risk of code P29.

5. Conduct internal audits and quality checks: Implement regular internal audits and quality checks to identify any potential coding errors or discrepancies that may lead to code P29. By catching and resolving these issues early on, you can prevent denials and ensure accurate reimbursement.

6. Collaborate with payers and clearinghouses: Maintain open lines of communication with payers and clearinghouses to address any questions or concerns related to code P29. This collaborative approach can help resolve issues promptly and prevent future occurrences of this denial code.

Remember, these strategies are general recommendations and may vary depending on your specific healthcare organization and payer contracts. It is important to assess your unique situation and tailor these strategies accordingly.

How to Address Denial Code P29

The steps to address code P29 are as follows:

1. If the adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF).

2. If the adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply.

3. This code is specifically applicable to Property and Casualty Auto claims only.It is important for healthcare providers to follow these steps when addressing code P29 to ensure accurate billing and reimbursement.

RARCs Associated to CARC P29

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