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Edit 000526
Prescription / Order Number is Missing
HIPAA Claim Adjustment Reason Code:
175
Remark Code: N/A
HIPAA Healthcare Claim Status Code: 219
Entity Identifier Code: N/A
Potential Causes:
This edit will only affect the 837P for Durable Medical Equipment (DME) and Hearing Aid providers. The procedure requires a prescription/order number and it was not on the claim.
Solution:
Please verify that the prescription or order number that you submitted is correct. If it is correct, please make sure it was entered correctly in the following loop and segments.
| 837 Professional Only |
Loop 2300, REF (Prior Authorization or Referral Number)
REF01 = G1 (Reference Identification Qualifier)
REF02 = Prior approval/Order number (Reference Identification)
Loop 2400, REF (Prior Authorization or Referral Number)
REF01 = G1 (Reference Identification Qualifier)
REF02 = Prior approval/Order number (Reference Identification)
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Note: For DME services, the prescription/order number is 7 digits.
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