Edit 00110

Medicare Data Inconsistent

HIPAA Claim Adjustment Reason Code: 16
     Remark Code: MA92
HIPAA Healthcare Claim Status Code: 182
     Entity Identifier Code: N/A

Potential Causes:
When submitting a Paper Claim and the patient has Medicare, both the Medicare
Approved Amount and the Medicare Paid Amount must be given. If only one or the other is reported the claim will fail edit 00110.

Solution:
Check Medicare data reported as the Medicare paid amount and the Medicare approved amount in Box 24J and Box 24K. In addition, check the Payment Source Code entered in Box 23B. For detailed instructions on the completion of Box 23B, please refer to the Billing Manual applicable to the type of billing submitted, on eMedNY.org by clicking on the Provider Manual Tab.