Medicare Claims Processing Manual (Pub. 100-04), Ch. 18 § 20.8.1
MSN Messages
20.8.1 - MSN Messages
(Rev. 3961, Issued: 02-02- 18, Effective: 01-01- 18, Implementation: 07-02-18)
B3-4601.4, A3-3660.10.I
The following messages are used on the MSN.
If the claim is denied because the beneficiary is under 35 years of age, use the following MSN:
MSN 18.3:
Screening mammography is not covered for women under 35 years of age.
The Spanish version of this MSN message should read:
Las pruebas de mamografía para mujeres menores de 35 años no están cubiertas.
If the claim is denied for a woman 35-39 because she has previously received this examination, use
the following MSN:
MSN 18.6:
A screening mammography is covered only once for women age 35-39.
The Spanish version of this MSN message should read:
Una mamografía de cernimiento es cubierta una vez solamente para mujeres entre las
edades de 35-39.
If the claim is denied because the period of time between screenings for the woman based on age
has not passed, use the following MSN:
MSN 18.4:
This service is being denied because it has not been 12 months since your last examination
of this kind. (NOTE: Insert appropriate number of months.)
The Spanish version of this MSN message should read:
Este servicio se denegó debido a que no han transcurrido 12 meses desde su último examen
de este tipo.
If the claim is denied because the provider is not certified to perform a mammography, use the
following MSN:
MSN 16.2:
This service cannot be paid when provided in this location/facility.
The Spanish version of this MSN message should read:
Este servicio no se puede pagar cuando es suministrado en este sitio/facilidad.
In addition to the above denial messages, the A/B MAC (A) or (B) may add the following:
MSN 18.12:
Screening mammograms are covered annually for women 40 years of age and older.
The Spanish version of this MSN message should read:
El examen de mamografía de cernimiento se cubre una vez al año para mujeres de
40 años de edad o más.
For A/B MACs (B) only:
For claims submitted with invalid or missing certification number, use the following MSN:
MSN 9.2:
This item or service was denied because information required to make payment
was missing.
The Spanish version of this MSN message should read:
Este artículo o servicio fue denegado porque la información requerida para hacer el
pago fue omitida.