Explanation codes are printed on your Remittance Advice (RA) to identify the reason a claim line pended or rejected.  Make sure you review all codes printed for each claim and read the description.  Many of the codes have rebilling instructions or information that will assist you with future claims.

EXPLANATION CODE CROSSWALK -    PDF     EXCEL

The Explanation Code Crosswalk should be used in conjunction with your paper remittance advice (RA) to assist you with understanding why your claim was paid or rejected.  The paper RA reports the HIPAA compliant Group Codes, Claim Adjustment Reason Codes, and Remittance Advice Remark codes along with the MDCH proprietary explanation codes to accurately inform providers about the status of their claims.