|
Edit 00657
Stay Denied Effective Date Not Prior To Statement Thru Date
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N50
HIPAA Healthcare Claim Status Code: 190
Entity Identifier Code: N/A
Potential Causes:
The date entered on the claim as the Stay Denied Effective date is not prior to the Thru Date of Service entered on the claim. If a Stay Denied Effective Date is to be used, then it must be before the Thru Date of Service due to the nature of the usage of the Stay Denied Effective date. (The Stay Denied Effective Date is only used when it is determined by Medical Review that the Discharge of the Patient should have occurred prior to when the actual discharge occurred.)
Solution:
Enter the correct Stay Denied Effective Date and/or the Thru Date of Service. If it is determined that the Stay Denied Effective date was entered in error, then delete the entry and resubmit using the loops and segments provided below.
| 837 Institutional |
Loop 2300, DTP (Statement Dates)
DTP01 = 434 (Date/Time Qualifier)
DTP02 = D8 or RD8 (Date Time Period Qualifier)
DTP03 = Format CCYYMMDD or CCYYMMDD-CCYYMMDD (Date Time Period)
And
Loop 2300 HI (Occurrence Information)
HI01-1 = BH (Occurrence)
HI01-2 = 22 (Date Active Care Ended (formerly known as Stay Deny Effective Date))
HI01-3 = D8 (Discharge Date expressed in Format CCYYMMDD)
HI01-4 = Discharge Date |
|
