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Edit 00570
No Price on Drug File
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N65
HIPAA Healthcare Claim Status Code: 220
Entity Identifier Code: N/A
Potential Causes:
There is no price on file for the Formulary Code entered on the claim. The lack of a price on file renders the code invalid.
Solution:
Check the Formulary Code entered on the claim in the Medicaid Fee Schedule. Contact Provider Services if additional assistance is needed. 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)
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