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Edit / Error Knowledge Base > Select Edit Range >

Edits
Edit Range	Edits
01201 to 01300

01201 - MANAGED CARE COORDINATION SERVICE NOT PROVIDED/ORDERED/REFERRED BY PRIMARY PHYSICIAN/ATTACHMENT
01202 - MANAGED CARE COORDINATION SERVICE NOT PROVIDED/ORDERED/REFERRED BY PRIMARY CLINIC
01204 - DUR NOT PERFORMED PRIOR TO DISPENSING DRUG
01205 - PROCEDURE CODE ONLY VALID FOR CARE AT HOME RECIPIENT
01206 - RECIPIENT NOT IN CARE AT HOME PROGRAM-INVALID RATE CODE BILLED
01207 - CARE AT HOME RATE DOES NOT MATCH RECIPIENTS PROGRAM
01208 - ASSISTED LIVING PROGRAM RECIPIENT/SERVICE INCLUDED IN PER DIEM
01209 - DESIGNATED MENTAL ILLNESS DIAGNOSIS REQUIRED
01210 - RECIPIENT AGE INVALID FOR EARLY INTERVENTION CLAIM
01213 - CLAIM MUST BE SUBMITTED ELECTRONICALLY USING HIPAA COMPLIANT ANSI X12 837 CLAIM SUBMISSION FORMAT
01220 - DAY TREATMENT RATE INVALID FOR PRINCIPLE PROVIDER CODE
01224 - INVALID DIAGNOSIS CODE FOR OMR HOME AND COMMUNITY BASED SERVICES WAIVER CLAIM
01225 - DATE OF SERVICE MUST BE 2ND OF MONTH - OMH
01226 - SECOND HALF SEMI-MONTHLY DATE OF SERVICE (DAY) NOT EQUAL 02 OMR
01229 - RATE CODE INVALID FOR RECIPIENT EXCEPTION CODE
01231 - INAPPROPRIATE RATE BILLED/CONFLICTING CLAIM PREVIOUSLY PAID
01236 - ORDER/REFERRING LICENSE NOT ON NYS LICENSE FILE
01237 - PRESCRIBER LICENSE NOT ON NYS LICENSE FILE
01238 - SERVICE LICENSE NOT ON NYS LICENSE FILE
01239 - ORDERER/PRESCRIBER WAS EXCLUDED PRIOR TO SERVICE DATE
01240 - RESTRICTED RECIPIENT INPATIENT SERVICE NOT PROVIDED/ORDERED/REFERRED BY PRIMARY PROVIDER
01242 - ORDERING / REFERRING PROVIDER NOT IN ACTIVE STATUS ON DATE OF SERVICE
01243 - PRESCRIBING PROVIDER NOT IN ACTIVE STATUS ON DATE OF SERVICE
01244 - SERVICE PROVIDER NOT IN ACTIVE STATUS ON DATE OF SERVICE
01245 - RESTRICTED RECIPIENT INPATIENT SERVICE NOT PROVIDED/ORDERED/REFERRED BY PRIMARY PROVIDER/PEND FOR REVIEW
01247 - THERAPEUTIC DAYS GT 4 FOR RTF CLAIM, NO PA PRESENT
01249 - CONSECUTIVE THERAPEUTIC DAYS GREATER THAN 4 FOR RTF CLAIM, NO PRIOR AUTHORIZATION PRESENT
01250 - EXCEEDED MAX OF 75 THERAPEUTIC LEAVE DAYS IN A 12 - MONTH PERIOD
01252 - GROUP OPERATING CPD NOT FOUND FOR PROVIDER
01254 - CAPITATION CLAIM MUST COVER ENROLLMENT PERIOD
01257 - GME NOT BILLABLE AS A SEPARATE CLAIM
01258 - SERVICE/END SERVICE/DISCHARGE DATES MUST BE EQUAL ON A GRADUATE MEDICAL EXPENSE CLAIM
01260 - PREPAID CAPITATION PLAN RECIPIENT - RATE CODE REQUIRES DATE OF SERVICE WITHIN 2 DAYS OF DATE OF BIRTH
01261 - GRADUATE MEDICAL EXPENSE NO REIMBURSABLE FOR MEDICARE DEDUCTIBLE/COINSURANCE CLAIM
01264 - NOT A NYC RECIPIENT
01266 - RECIPIENT AGE INVALID FOR METHADONE MAINTENANCE TREATMENT PROGRAM
01268 - DOS FOR MMTP TOKEN CLAIM NOT A SUNDAY
01269 - STOP LOSS CLAIM NOT RECEIVED WITHIN 6 MONTHS OF YEAR END
01272 - CLAIM CONFLICTS WITH PREVIOUSLY STATE VOIDED CLAIM
01278 - NOT A TRAUMATIC BRAIN INJURY RECIPIENT: TRAUMATIC BRAIN INJURY SERVICES NOT REIMBURSABLE
01283 - UPPER DOLLAR LIMIT EXCEEDED
01287 - DATE OF SERVICE FOR TRAUMATIC BRAIN INJURY RATE NOT FIRST OF MONTH
01288 - CLAIM FOR SAME SERVICE PREVIOUSLY REVIEWED AND DENIED
01292 - DATE OF SERVICE TWO YEARS PRIOR TO DATE RECEIVED
01293 - PROVIDER/GROUP REIMBURSED FOR MEDICARE ONLY
01294 - RECIPIENT NOT QMB (QUALIFIED MEDICARE BENEFICIARY), SERVICES NOT REIMBURSABLE
01295 - RECIPIENT NOT MEDICARE, SERVICES NOT REIMBURSABLE
01296 - BED RES / THERA LVE DAYS NOT ALLOWED FOR COV CD H RECIP
01300 - MANAGE CARE COORDINATION PROGRAM INPATIENT SERVICE NOT PROVIDED/ORDERED/REFERRED BY PRIMARY PROVIDER

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