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QUESTION: DDE: I have a claim which was fully denied and I am attempting to use the new automated denial adjustment process, but the DDE system is not allowing me to adjust my claim. Why am I not able to bring up my claim and submit the adjustment?

Answer

A claim which has been denied at the claim level cannot be accessed in the DDE adjustment menu and must be appealed. If you are adjusting a partially denied claim you must use a D1 condition code and an LN adjustment reason code on the adjusted claim. Also include remarks clarifying what is being changed from the previous submission.


Reviewed Date: 10/15/19
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