Wellness
What is the subtype for a wellness exam?
WAE
What is the difference between the subtypes "NCW" and NCM"?
NCW-Non Compensable Wellness
NCM- Non Compensable Medical
What subtype is used for routine teeth cleaning?
TCC
What pre-existing event is represented by reason code 384?
Cruciate ligament events
What code would be used when splitting an invoice that includes both wellness and illness?
290
What reason code would be used on a wellness claim when there is no wellness rider?
243
What reason code would you use to deny Hazardous Waste Fees?
221
What reason code would you use to deny dental products?
298
What pre-existing exclusion is represented by code 352?
Bilateral Condition
Under APIC and IAIC policies, what reason code would be used for denying breeding and pregnancy related conditions?
382
What service would the subtype CAL be used for?
Lepto vaccine under APIC/IAIC Ann4/MST
What would you be denying if you used reason code 400?
Tech fee
True or False: Subtype TCC can be used with a Best Wellness rider for a non-anesthetic dental cleaning?
True
What reason code would you use if the pet had a mass or other s/s of cancer previously?
348
What service does the subtype HOA represent?
Acupuncture, electro-acupuncture, and chiropractic services
What subtype would be used for a cryptorchid neuter?
SNC
What is reason code 226 used for?
Bathing and grooming services
What reason code would you use if the dental condition claimed is not part of policy coverage (Excluded dental conditions)?
379
DOS falls within the WP for an accident only policy. What reason code would you use?
215
Pet lives in New York and presents to vet 3 months after PED. MR indicate that pet began limping 1 week ago and does not have any history of previous s/s. Owner declined diagnostics and opted for conservative treatment. What reason code would you use?
291
What explanation does reason code 245 stand for?
No wellness-teeth cleaning
What denial is coded with 260?
Costs for training and behavioral therapy
What does the reason code 380 stand for?
The condition claimed is not part of policy coverage if the pet was not enrolled prior to becoming 6 months of age.
Pet started coughing on 1/15/26. PED was on 1/24/26. DOS is 2/10/26 where MR indicate coughing has persisted since first beginning and pet was diagnosed with CHF. What code would you use?
208
This reason code would be used for any event that occurred or displayed s/s within 18 months prior to the PED/WP.
351