Denial Resolution Tool

Denial Evidence Packet Builder

Turn a denial family into a controlled checklist for triage, evidence collection, resolution routing, and prevention.

Use de-identified facts only. Do not type or print patient names, Medicare identifiers, claim numbers, dates of birth, medical records, or other protected information into this public tool.

Denial family

Likely route

Correct and resubmit

0 of 7 packet controls checked

The modifier may be absent, invalid for the code, inconsistent with other claim facts, or unsupported by the record.

Triage checks

Read the exact RARC or edit response.Check code, setting, date, provider, and related services.Identify the source rule and record fact supporting or prohibiting the modifier.

Evidence packet

Medical recordCurrent modifier definitionNCCI edit and policyRelated claim lines

Resolution sequence

01Correct a missing or invalid modifier when the original record supports it.
02Remove an unsupported modifier and rebill if appropriate.
03Appeal only when the modifier and separate-service facts are documented.
04Audit recurring defaults in the charge master or EHR.

Open full denial guide Plan deadline