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Denial Code 14

Definition:

The patient's date of birth is after the date of service.

What is Denial Code 14?

Denial Code 14 means the claim shows a date of service that occurred before the patient's recorded date of birth.

For example, if the patient's date of birth is recorded as August 10 but the claim shows that treatment occurred on August 5 of the same year, the payer cannot process the claim because the dates are logically inconsistent.

This is usually caused by an incorrect date of birth, incorrect date of service, or selection of the wrong patient record.

Example 1#
Scenario:

An infant is born on May 12, 2026 and receives a 1-month well-child examination, CPT 99391, on June 15, 2026.

During manual charge entry, the biller accidentally enters the date of service as May 5, 2026 and billed to Aetna commercial.

Aetna Commercial compares the submitted service date with the infant's May 12 date of birth and denies the claim with Denial Code 14.

Let's break down the issue:
  • Denial Code 14 means the payer received a date of service that occurs before the patient's date of birth.
  • The infant's correct date of birth is May 12.
  • The actual well-child visit occurred on June 15.
  • However, the claim mistakenly reports May 5, which is seven days before the infant was born.
  • The payer sees an impossible pre-birth office visit and denies the service.
Resolution:
Review the pediatrician's signed encounter note and verify that the actual date of service was June 15, 2026. Correct the submitted service date from May 5 to June 15 and submit the appropriate corrected claim to Aetna.
Example 2#
Scenario:

A maternal-fetal medicine specialist performs an in-utero fetal echocardiogram, CPT 76825, on March 10, 2026, during an ongoing pregnancy.

The baby is born on April 1, 2026. After birth, the hospital creates a separate newborn insurance account.

During late charge processing, the billing staff accidentally submitted a March 10 fetal echocardiogram under the newborn's new member record, which listed an April 1 date of birth.

BCBS compares the March 10 service date with the newborn's April 1 DOB and denies the claim with Denial Code 14.

Let's break down the issue:
  • The fetal echocardiogram really did occur before the baby's date of birth because it was an in-utero service.
  • CPT 76825 specifically describes an initial fetal echocardiographic examination.
  • The problem is not that the fetal service was medically impossible (for new born baby).
  • The billing problem occurred because the pre-birth service was incorrectly attached to the newborn's post-birth insurance record.
  • The claim should be billed under the pregnant patient's record and insurance ID specifically for pregnant patient.
Resolution:
Void the claim that was incorrectly submitted under the newborn's member record. Transfer the charge to the mother's record, and bill the claim to BCBS under the mother's specific member ID using the correct diagnosis and CPT codes supported by the medical record.
Example 3#
Scenario:

A premature infant is delivered by emergency C-section on August 10, 2026 and immediately admitted to the Neonatal Intensive Care Unit.

During emergency Medicaid enrollment, the infant's date of birth is accidentally entered into the state Medicaid eligibility system as August 20, 2026.

The hospital submits neonatal critical-care services beginning August 10 to the Medicaid Managed Care Organization.

Because the MCO's eligibility file shows that the infant was not born until August 20, the August 10–19 services are denied with Denial Code 14 and remark code N329.

Remark Code N329: "Missing/incomplete/invalid patient birth date."

Let's break down the issue:
  • The hospital's clinical record is correct: the infant was actually born on August 10. And the NICU services provided beginning from August 10 also legitimate.
  • The problem exists in the state Medicaid master eligibility record, which incorrectly shows August 20 as the date of birth.
  • RARC N329 specifically identifies missing, incomplete, or invalid patient birth-date information.
  • The MCO generally receives eligibility/member information from the state Medicaid enrollment system.
  • Sending the same claim again while the state eligibility record still shows August 20 will likely produce another CARC Code 14 denial nor any claim modifier can fix an incorrect masster demographic record.
Resolution:
Verify the correct August 10 date of birth using the hospital delivery record and official birth documentation. Work with the parent/legal guardian, hospital eligibility team, and applicable state Medicaid eligibility agency to correct the infant's date of birth in the state master enrollment system. After the state confirms that the DOB has been changed to August 10, 2026, verify that the corrected eligibility information has reached the Medicaid MCO. Then request claim reprocessing or submit the required corrected claim. If timely filing became an issue because the state demographic correction was delayed, include documentation of the eligibility error and correction with the applicable timely-filing reconsideration as a prove.

Why Does Denial Code 14 Occur?

  1. The patient's date of birth was entered incorrectly.
  2. The date of service was entered incorrectly.
  3. The wrong patient's account was selected.
  4. The payer has an incorrect date of birth in its records.
  5. A typing error occurred during patient registration or charge entry.
  6. The provider's information and payer's demographic information do not match.

How to Avoid / Ways to Mitigate Denial Code 14?

  1. Verify Date of Birth During Registration: Confirm the patient's date of birth from reliable registration or insurance information before creating the claim.
  2. Check the Date of Service: Compare the claim with the medical record and make sure the correct service date was submitted.
  3. Verify the Correct Patient: Make sure the service was posted to the correct patient's account, especially when patients have similar names.
  4. Compare With Payer Records: Use eligibility information to identify differences between the practice's date of birth and the payer's records.
  5. Correct the Source of the Error: Correct inaccurate practice information or have incorrect payer records updated before resubmitting the claim.
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