Advanced Practice Registered Nurse (APRN) Claim Denials

September 24, 2012

APRNs had claims that were denied in error for the following reasons:

  • MIHMS Edit 330- Invalid diagnosis for benefit
  • CARC 11 - The diagnosis is inconsistent with the procedure
  • RARC M64 - Missing/incomplete/invalid other diagnosis

This issue has been resolved and all affected claims will be re-processed. Providers do not need to re-submit these claims.