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Edit 00931
Required Tooth for Procedure Invalid
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N39
HIPAA Healthcare Claim Status Code: 242
Entity Identifier Code: N/A
Potential Causes:
The procedure billed requires a Tooth Number, but it is missing.
Solution:Please check your information, enter the data in the loop and the segment provided, and resubmit.
Please refer to the 837 Dental Supplemental Companion Guide on this site (www.nyhipaadesk.com) for information on Data Element (D.E.) 3112 Tooth Quadrant Arch.
| 837 Dental |
Loop 2400, SV3 (Dental Service)
SV304 -1 = Oral Cavity Designation Code
And
Loop 2400, TOO (Tooth Information)
TOO02 = Tooth Number |
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