This article is for dentists and oral surgeons caring for our members
Periodically we’ll be bringing you important information to help you avoid having your claims rejected. Below we’ve explained some common reasons why claims are rejected, and the Provider Detail Advisory/Provider Voucher messages you’ll receive for each. We’ve also outlined best practices for how to resolve the problem.
| When the rejection code and message is | This means that | And you should |
|---|---|---|
| B592: This service is not a covered benefit when performed on a patient of this age. | The patient is not old enough for the service that is being billed | Confirm that the procedure code and tooth number combination being billed is correct.
|
| X284: We are unable to pay for this service without additional information the procedure you have submitted requires a valid tooth number(s), quadrant or arch identification and/or tooth surface(s). Please resubmit a claim for this service with the required information for processing. Thank you. | The procedure code needs additional information so we can process the claim correctly. | Confirm that the procedure code and tooth number/ surface or additional identifiers are being billed is correctly. If the information is:
|
Resources:
Dental Blue Book
CDT Coding Guidelines
To verify claims payment and search for claims, refer to www.payspan.com
To verify benefits, eligibility, and claim status on Dental Connect
Dental Blue Book CDT Coding Guidelines
To verify claims payment and search for claims, refer to payspan.com
To verify benefits, eligibility, and claim status on Dental Connect
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