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Edit 00927
Modifier Invalid for Submitted Procedure Code
HIPAA Claim Adjustment Reason Code: 4
Remark Code: N/A
HIPAA Healthcare Claim Status Code: 463
Entity Identifier Code: N/A
Potential Causes:
A Modifier was used with a Procedure Code that should not have a modifier.
Solution:
Please check your information for Procedure Code and Modifier in the loop and segments provided and re-submit
| 837 Institutional |
Loop 2400, SV2 (Institutional Service Line) - (Non-Inpatient)
SV202-1 = HC (Product/Service ID Qualifier)
SV202-2 = Procedure Code – Enter HCPCS procedure code (Product/Service ID)
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| 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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| 837 Dental |
Loop 2400, SV3 (Dental Service)
SV301-1 = AD (Product/Service ID Qualifier)
SV301-2 = Procedure Code (Product/Service ID)
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