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Edit / Error Knowledge Base > Select Edit Range >


Edits

Edit Range Edits
00701 to 00800
00702 - SERVICE DATE NOT WITHIN PA APPROVED DATE RANGE
00703 - INAPPROPRIATE SECOND SERVICE - SAME DAY
00705 - DUPLICATE CLAIM IN HISTORY
00706 - STOP-LOSS REQUIRES MANUAL PRICING
00707 - EXACT DUP CATCH ALL PROCEDURE
00708 - CONFLICTING PAC RATE CODE IN HISTORY
00709 - RECIPIENT INELIGIBLE (COVERAGE CODE IS EQUAL TO 08)
00710 - PROCEDURE/FORMULARY CODE EXCEEDS SERVICE LIMITS
00712 - PROC EXCEEDS SERVICE LIMITS
00713 - CLIENT HAS MEDICARE PART B AND MEDICAID OTHER IS BLANK
00715 - PROCEDURE CONFLICTS WITH PRIOR SERVICE
00717 - PROCEDURE CONFLICTS WITH PRIOR SERVICE
00718 - PROCEDURE COMBINATION REQUIRES REVIEW/PRICING
00719 - PROVIDER ID AND ORD/REF/PRES ID ARE IDENTICAL
00721 - CLAIM PATIENT PART > 1000 AND FILE PATIENT PART = 0
00722 - CLAIM PATIENT PART AMOUNT 10 OR MORE TIMES > FILE PATIENT PART AMOUNT
00725 - HISTORY RECORD NOT FOUND FOR ADJUSTMENT OR VOID
00726 - PATIENT PARTICIPATION AMOUNT ON STATE SUBMITTED ADJUSTMENT MISSING
00727 - NEAR DUPLICATE CLAIM IN HISTORY
00728 - PA REQUIRED - STAY GT 15 DAYS OR LEVEL OF CARE CHANGED
00736 - DIAGNOSIS CODE BLANK A FULL ICD-9 CM CODE REQUIRED
00738 - ICD-9-CM DIAGNOSIS CODE ON PHYSICIAN CLAIM NOT ON FILE
00743 - DOS FOR WEEKLY RATE NOT ON A SUNDAY
00744 - DIAGNOSIS CODE NOT VALID FOR AIDS RATE CODE
00746 - NO SERVICE AUTHORIZATION RECORD ON FILE
00747 - CLAIM TYPE NOT FOR PRIOR APPROVAL RECORD CLASS
00748 - SERVICE AUTHORIZATION RECORD EXHAUSTED
00749 - SERVICE AUTHORIZATION EXCEPTION CODE MISUSED; ACCESS EMEVS
00753 - ONLY UPSTATE CONTRACTOR ALLOWED TO BILL FOR SERVICE
00755 - THIS REFILL ALREADY PAID
00756 - DUPLICATE INSTITUTIONAL / PROFESSIONAL CLAIM
00757 - SUSPECT DUPLICATE PROFESSIONAL, COVERED BY INSTITUTIONAL CLAIM
00758 - DUPLICATE INPATIENT / PHARMACY CLAIM
00759 - DUPLICATE INPATIENT / CLINIC, EMERGENCY, REFERRED AMB OR LAB CLAIM
00760 - SUSPECT DUPLICATE, COVERED BY INPATIENT CLAIM
00761 - DUPLICATE DAY TREATMENT CLINIC / PART-TIME CLINIC CLAIM
00762 - SUSPECT DUPLICATE, COVERED BY PART-TIME CLINIC CLAIM
00763 - DUPLICATE CLINIC (0160) / CLINIC (0164)
00764 - SUSPECT DUPLICATE, COVERED BY CLINIC (COS 0160)
00765 - SUSPECT DUPLICATE PHARMACY, COVERED BY INPATIENT CLAIM
00766 - DUPLICATE DENTAL / CLINIC CLAIM (0164)
00774 - GROUPER ABEND/INTERNAL RECYCLE
00775 - DRG EQUALS 469 (PRIMARY DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS)
00776 - SIW VALUES FOR THE DRG INDICATED NOT FOUND
00777 - HOSPITAL LOCATION FOR THE DRG NOT FOUND ON CPG TABLE
00778 - CAPITAL ADD ON RATE NOT FOUND FOR PROVIDER
00780 - INVALID RATE CODE FOR INPATIENT CLAIM
00782 - FOR ACUTE DRG CLAIMS THE DISCHARGE DATE MUST BE AFTER END DATE
00784 - SUBSEQUENT DRG BILLS MUST BE AFTER THE THRESHOLD DATE
00785 - ALTERNATE LEVEL OF CARE (ALC) CLAIMS REQUIRE AN ALC DATE
00786 - SERVICE FROM DATE PRIOR TO ALC DATE FOR ALC CLAIMS
00787 - FROM,ADMIT,AND END DATE MUST BE EQUAL ON ADMIT DRG CLAIM
00788 - DISCHARGED STATUS NOT ALLOWED FOR ADMIT DRG CLAIMS
00789 - STATEMENT FROM DATE NOT EQUAL ADMIT DATE FOR DRG CLAIM
00790 - DAYS LESS THAN THRESHOLD AND STILL A PATIENT OR DIED
00791 - DRG EQUALS 470 (GROUPER WAS UNABLE TO DETERMINE A VALID DRG)
00792 - ADMIT DATE EQUALS FROM DATE ON OUTLIER CLAIM
00793 - PART-A DAYS WITH MEDICAID DAYS NOT ALLOWED ON DRG CLAIM
00794 - OUTLIER PAYMENT NOT ALLOWED FOR TRANSFERS
00795 - COST OUTLIER CLAIM REQUIRES MANUAL PRICING
00800 - PATIENT STILL IN HOSPITAL DISCHARGE DT OR HOUR PRESENT
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