MedicaidAdministrativeMedium impact
Attention All Providers: Top Claim Denial Reasons and Resolutions/Workarounds for December 2024 Professional Claims
Nevada Medicaid·NV·Billing & Coding
Effective date
Jan 24, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has released guidance on the top professional claim denial reasons from December 2024, providing specific error codes, EOB codes, and resolution steps. This informational update helps providers understand common denial patterns and provides workarounds for issues like Medicare crossover problems, coverage verification, prior authorization denials, and timely filing requirements.
Action Required
Immediately: Billing team should review the 9 common denial error codes (452, 3340, 4021, 2003, 676, 3001, 2017, 4371, 5035) and their resolutions. Update denial management workflows to include the specific workarounds provided. Train staff on using EVS system for eligibility verification and ensure timely filing procedures meet Nevada Medicaid requirements (180 days in-state, 365 days out-of-state/TPL). Reference the provided training videos and billing manual for detailed guidance.