|
Edit 00562
Drug Price not Available on Fill Date
HIPAA Claim Adjustment Reason Code: 16
Remark Code: M84
HIPAA Healthcare Claim Status Code: 220
Entity Identifier Code: N/A
Potential Causes:
The Formulary Code used on the claim is not on file as a valid Formulary Code.
Solution:
Validate the Formulary Code entered, using the Medicaid Fee Schedule. Enter the data in the loop and the segments provided, and resubmit.
| 837 Professional |
Loop 2400, SV1 (Professional Service)
SV101-1 = HC (Product/Service ID Qualifier)
SV101-2 = Procedure Code (Product/Service ID)
|
|
