From the rejection message, it appears that the service code (CPT code) you used is not valid for the diagnosis code (ICD-9/10) you have entered for the patient for this payer. If you feel this is not the case, then you may need to call the payer to verify why they are rejecting your claim.
Articles in this section
- Diagnosis Code Not Billable
- Referring prov first and last name must be in separate fields and both are required
- Element CAS02 (Claim Adjustment Reason Code) is missing. This Elements standard option is Mandatory. Segment CAS is defined in the guideline at position 5450
- A3 143 P406 BILLING NPI REQUIRES RENDERING NPI
- SERVICE LINE COB INFORMATION: INVALID; THE SUM OF ALL SERVICE LINE PAID AMOUNTS PLUS THE SERVICE LINE ADJUSTMENT AMOUNTS FOR EACH PAYER MUST EQUAL LINE ITEM CHARGE AMOUNT
- Invalid Referring Physician NPI Format (Box 17B) - Fails Validation
- Element CRC03 (Condition Indicator) does not contain a valid identification code: YES is not allowed. Segment CRC is defined in the guideline at position 2200. Invalid data: YES
- DATES OF SERVICE NOT IN INSURED POLICY DATES :
- DTP03 NOT IN POLICY DATE RANGE
- Facility Type Code 99 invalid for BCBSNC business.