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Edit 00692
Date of Service must be 1st of Month
HIPAA Claim Adjustment Reason Code: 16
Remark Code: M52
HIPAA Healthcare Claim Status Code: 187
Entity Identifier Code: N/A
Potential Causes:
The date entered is the 1 st of the Month after the Month that the service was rendered.
Solution:
Check the Date of Service to insure it is the First of the Month. (If the patient lost eligibility prior to the first of the month and the last day of eligibility was billed, then check the eligibility of the patient with the Office of Medicaid Management or contact Provider Services.)
Check the Rate Code to ensure that the proper service was billed. Enter the data in the loops and segments provided and resubmit.
| 837 Institutional |
Loop 2300, DTP (Statement Dates)
DTP01 = 434 (Date/Time Qualifier)
DTP02 = D8 (Date Time Period Format Qualifier)
DTP03 = Format CCYYMMDD (Statement From or To Date)
Loop 2300, HI (Value Information)
HI01-1 = BE (Code List Qualifier Code)
HI01-2 = 24 (Value Code)
HI01-5 = 4 Digit Rate Code (Value Code Associated Amount)
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