Reason Code: 53NCD
Error Description:
Line level denial indicating none of the ICD-10-CM diagnosis codes on the claim support the medical necessity of the service(s) billed. The claim included the GA modifier and/or occurrence code 32 indicating that an ABN was issued; therefore, the beneficiary is liable for the denied services.
Avoiding/Correcting This Error
Ensure all claim coding is accurate prior to submitting the claim.
Verify billing and, if appropriate, submit an adjustment to correct the diagnosis code according to instructions in the NGS article Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials.