Thursday, May 27, 2010

Multiple carrier TPR codes




MP Primary insurance paid – secondary paid
SU Primary insurance paid – secondary under deductible
MU Primary and secondary under deductible
PU Primary insurance under deductible – secondary paid
SS Primary insurance paid – secondary service not covered
SC Primary insurance paid – secondary patient not covered
ST Primary insurance paid – secondary canceled/terminated
SL Primary insurance paid – secondary lapsed or not in effect
SP Primary insurance paid – secondary payment went to patient
SH Primary insurance paid – secondary payment went to policyholder
SA Primary insurance paid – secondary denied – service not authorized
SE Primary insurance paid – secondary denied – service not considered emergency
SF Primary insurance paid – secondary denied – service not provided by primary care provider/facility
SM Primary insurance paid – secondary denied – maximum benefits used for diagnosis/condition
SI Primary insurance paid – secondary denied – requested information not received from policyholder
SR Primary insurance paid – secondary denied – requested information not received from patient
MC Service not covered by primary or secondary insurance
MO Other (if above codes do not apply, include detailed explanation of why there was no payment from insurances)

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