Professional Basics
Procedure code not found
BPC
Non-par lab pricing
NPL
Zero allowance found on claim
ALZ
Interim billing adjustment needed
INT
Bill types 111, 112 and have a case allowance
Inpatient Claim
Duplicate claim
DUP
Claim is returned from MARS with pricing determinations/instructions
NRR
Ambulance must be priced per line
AMB
Device intensive pricing review
ISU
Pricing Method/Rule 20/012/028
Per diem
Other insurance carrier information needed
EOB
Provider is mismatch and it MUST match
PBE
Claim submitted on wrong form, should be CMS-1500
CMS
Provider under review only
PBR
System used to house claims
POWER
ITS
PCR
DRG 998/999 triggers routing
DRG
Unknown EX code returned
PEX
15-digit number that is created when a claim is entered into the system. BlueCard starts with "520"
SCCF number
NPI
NOC code under review
U99
Gamma knife procedure review
GAM
PPM timeout reprocess
PPM