TRICARE Overseas Program Provider Manual

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TRICARE overseas Program Provider Manual SECTIoN 8: List of Acronyms AAP ADFM ADSM CAC CDC CoNUS CPT DHA DMEPoS DoB DoD DRG ECHo EDI EFT EoB FY HPV ICD ICN MHS MRI oHI SSN TFL ToP TRR TRS TYA UCCI WPS American Academy of Pediatrics Active Duty Family Member Active Duty Service Member Common Access Card Centers for Disease Control Continental United States Current Procedural Terminology Defense Health Agency Durable Medical Equipment, Prosthetics, Orthontics and Supplies Date of Birth Department of Defense Diagnosis-related Group TRICARE Extended Health Care Option Electronic Data Interchange Electronic Fund Transfer Explanation of Benefits Fiscal Year Human Papillomavirus International Classification of Diseases Internal Control Number Military Health System Magnetic Resonance Imaging Other Health Insurance Social Security Number TRICARE for Life TRICARE Overseas Program TRICARE Retired Reserve TRICARE Reserve Select TRICARE Young Adult Program United Concordia Companies, Inc. Wisconsin Physicians Service 108
TRICARE overseas Program Provider Manual Appendix ToP: Explanation of Benefits Denial Codes and Remarks Code Description Additional Information 003 See Item Five on Reverse. If you are not satisfied with our determination, you have the right to request a review within 90 days of the date of this notice. SECTIoN 8 / APPENDIX Acronyms 004 Non-prescription drug – see Item Four on Reverse. 008 Routine X-ray not covered – see Item Four on Reverse. 009 Non-covered routine eye examination – see Item Four on Reverse. 010 Routine lab not covered – see Item Four on Reverse. 013 Eyeglasses/lenses not covered – see Item Four on Reverse. 014 Routine foot care not covered – see Item Four on Reverse. 018 Provider not TRICARE-authorized for this service. 019 Personal comfort item not covered – see Item Four on Reverse. 020 This charge included in a paid service. This is used when the Provider is billing for a procedure that is already accounted for in another procedure. For example, removal of cerumen (ear wax) is included in the office visit charge. 027 Authorized service limits exceeded – see Item Four on Reverse. 028 Requested Information Not Received. 030 Service Filed After Time Limit. 032 Non-covered Services. 033 Duplicate of Services Previously Claimed (Manual). Services billed are not a covered service according to TRICARE Policy. Upon manual review, it was determined this charge is a duplicate and has been paid previously on another line/claim. 109
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TRICARE Overseas Program Provider Manual

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