| 01 | Price Authorization Expired Note: New as of 10/01 |
| 02 | Price authorization no longer required Note: New as of 10/01 |
| 03 | Product not on the price authorization Note: New as of 10/01 |
| 04 | Authorized Quantity Exceeded Note: New as of 10/01 |
| 05 | Special Cost Incorrect Note: New as of 10/01 |
| 06 | No Credit Allowed Note: New as of 10/01 |
| 07 | Administrative Cancellation Note: New as of 10/01 |
| 08 | Unit resale higher than authorized Note: New as of 10/01 |
| 09 | Out of Network Note: New as of 10/01 |
| 0A | Testing not Included Note: New as of 10/01 |
| 0B | Request Forwarded To and Decision Response Forthcoming From an External Review Organization Note: New as of 10/01 |
| 0C | Authorization/Access Restrictions Note: New as of 10/01 |
| 0D | Requires PCP authorization Note: New as of 10/01 |
| 0E | Provider is Not Primary Care Physician Note: New as of 10/01 |
| 0F | Not Medically Necessary Note: New as of 10/01 |
| 0G | Level of Care Not Appropriate Note: New as of 10/01 |
| 0H | Certification Not Required for this Service Note: New as of 10/01 |
| 0J | Certification Responsibility of External Review Organization Note: New as of 10/01 |
| 0K | Primary Care Service Note: New as of 10/01 |
| 0L | Exceeds Plan Maximums Note: New as of 10/01 |
| 0M | Non-covered Service Note: New as of 10/01 |
| 0N | No Prior Approval Note: New as of 10/01 |
| 0P | Requested Information Not Received Note: New as of 10/01 |
| 0Q | Duplicate Request Note: New as of 10/01 |
| 0R | Service Inconsistent with Diagnosis Note: New as of 10/01 |
| 0S | Pre-existing Condition Note: New as of 10/01 |
| 0T | Experimental Service or Procedure Note: New as of 10/01 |
| 0U | Additional Patient Information required Note: New as of 10/01 |
| 0V | Requires Medical Review Note: New as of 10/01 |
| 0W | Disposition pending review Note: New as of 10/01 |
| 0X | Service Inconsistent with Provider Type Note: New as of 10/01 |
| 0Y | Service inconsistent with Patient's Age Note: New as of 10/01 |
| 0Z | Service inconsistent with Patient's Gender Note: New as of 10/01 |
| 10 | Product/service/procedure delivery pattern (e.g., units, days, visits, weeks, hours, months) Note: New as of 10/01 |
| 11 | Pricing Note: New as of 10/01 |
| 12 | Patient is restricted to specific provider Note: New as of 10/01 |
| 13 | Service authorized for another provider Note: New as of 10/01 |
| 14 | Plan/contractual guidelines not followed Note: New as of 10/01 |
| 15 | Plan/contractual geographic restriction Note: New as of 10/01 |
| 16 | Inappropriate facility type Note: New as of 10/01 |
| 17 | Time limits not met Note: New as of 2/02 |
| 18 | Notification received Note: New as of 6/02 |
| 19 | Cosmetic Note: New as of 6/02 |
| 20 | Once in a lifetime restriction applies Note: New as of 2/04 |
| 21 | Transport Request Denied Note: New as of 6/04 |
| 22 | Ambulance Certification Segment information doesn't correspond to Transport Address Segment Note: New as of 6/04 |
| 23 | Mileage cannot be computed based on data submitted Note: New as of 6/04 |
| 24 | Computed mileage is inconsistent with transport information or service units submitted Note: New as of 6/04 |