Last Modified: 12/7/2022
Location: FL, PR, USVI
Business: Part A, Part B
The codes listed below cannot be corrected through the reopening process using SPOT.
Due to their nature, there are several modifiers and procedure codes in which claims may not be corrected through SPOT. In addition, if a claim includes the denial codes listed below, it cannot be corrected in SPOT.
Modifiers that cannot be corrected using SPOT:
21, 22, 23, 24, 51, 52, 53, 55, 56, 62, 66, 73, 74, 99, CC, GA, GM, GX, GY, GZ, PA, PB, PC, SG
CPT/HCPCS that cannot be corrected using SPOT:
90654, 90655, 90656, 90657, 90658, 90659, 90660, 90667, 90668, 90715, 90724, 90779, 96549, C9041, C9132, C9133, C9134, C9135, C9137, C9138, C9139, C9140, C9141, C9267, J0200, J0390, J0395, J0520, J0735, J1094, J1700, J1710, J1885, J1960, J1990, J2323, J2440, J2670, J2760, J3490, J3590, J7130, J7170, J7175, J7177, J7179, J7180, J7182, J7183, J7185, J7186, J7187, J7188, J7189, J7190, J7191, J7192, J7193, J7194, J7195, J7196, J7197, J7198, J7199, J7200, J7202, J7203, J7207, J7209, J7211, J7310, J7326, J7628, J7629, J7648, J7658, J7659, J7683, J7684, J8499, J9165, J9201, J9217, J9219, J9270, J9357, J9999, Q0144, Q0187, Q2022, Q2023, Q2027, Q2034, Q2035, Q2036, Q2037, Q2038, Q2039, Q2045, Q2046, Q9995
If a claim includes the following denial codes, it cannot be corrected using SPOT:
043, 051, 074, 083, 117, 118, 127, 135, 181, 224, 225, 226, 227, 235, 299, 300, 309, 310, 324, 346, 382, 387, 394, 395, 406, 413, 458, 483, 504, 512, 513, 531, 538, 552, 573, 581, 590, 596, 602, 627, 633, 634, 636, 637, 638, 650, 791, 792, 883, 889, 908, A18, A59, A60, A61, A62, A63, A64, A67, A75, A76, A82, AE2, AE7, AE8, AE9, C09, C10, C38, C39, C78, D01, D02, D03, D04, D05, D06, D07, D051, D083, D117, D118, D181, D224, D225, D382, D458, D504, D538, D627, D908, DA18, DA75, DA76, DA82, DC10, DC38, DC39, DC78, E14, E15, E19, E20, E21, E72, E85, E86, E88, E90, E96, E97, E98, H06, H82, H97, J61, J85, J86, J87, J89, K74, K78, K81, K88, K90, K92, K93, K94, K96, K97, K98
If your claim includes any of the modifiers, procedure codes, or denial codes listed above, you may submit a request for redetermination using SPOT’s Secure Documentation feature. Refer to the SPOT user guide
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.