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Edit 00935
Improper Number of Surfaces Indicated
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N75
HIPAA Healthcare Claim Status Code: 240
Entity Identifier Code: N/A
Potential Causes:
The number of surfaces indicated for a tooth procedure is invalid.
Solution:
Required if the procedure code requires tooth surface codes. The tooth surface codes should include values D, L, M, B, or F, and I or O. Please note: B and F are mutually exclusive; and also O and I are mutually exclusive if one of the pair is sent, the other cannot be sent in the same service line). Please enter no more than 5 surface indicators for a tooth procedure and resubmit using the loop and segment provided.
| 837 Dental |
Loop 2400, TOO (Tooth Information)
TOO03-1 = (Tooth Surface Code)
TOO03-2 = (Tooth Surface Code)
TOO03-3 = (Tooth Surface Code)
TOO03-4 = (Tooth Surface Code)
TOO03-5 = (Tooth Surface Code) |
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