Reason Code 5HMDP: Dependent Services Denied (Qualifying Service Denied Medically)

Published 12/10/2019

Reason for Denial
The dependent services will not be covered if the qualifying surgery has been denied. For example, the surgical procedure was denied as documentation did not support medical necessity, therefore all other charges cannot be allowed and will be denied as dependent to the medical denial of the qualifying service.

How to Avoid This Denial
Documentation that may be helpful to avoid future denials for this reason may include, but is not limited to, all documentation to support orders, documentation of services rendered and documentation of medical necessity for the qualifying services for the date(s) billed.