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Edit 01006
Thru Service Date Prior to From Service Date
HIPAA Claim Adjustment Reason Code: 16
Remark Code: MA31
HIPAA Healthcare Claim Status Code: 188
Entity Identifier Code: N/A
Potential Causes:
The Thru Date of Service (or End Date of Service) is after the Billing Date on the claim. The End Date has to be the same or before the Billing Date.
Solution:
Check the Thru Date of Service and the Billing Date to ensure the correct Dates are being entered. Enter the data in the loop and the segment provided, and resubmit.
| 837 Institutional |
Billing Date:
Segment BHT (Beginning of Hierarchical Transaction)
BHT04 = A Date in the format of CCYYMMDD (Date)
And
From and Thru Dates of Service:
Loop 2300, DTP (Statement Dates)
DTP01 = 434 (Date/Time Qualifier)
DTP02 = RD8 (Date Time Period Qualifier)
DTP03 = Format CCYYMMDD-CCYYMMDD (Date Time Period)
And
Loop 2400, DTP (Service Line Date)
DTP01 = 472 (Date/Time Qualifier)
DTP02 = RD8 (Range of Dates Expressed in Format CCYYMMDD – CCYYMMDD)
DTP03 = Range of Dates |
| 837 Professional |
Billing Date:
Segment BHT (Beginning of Hierarchical Transaction)
BHT04 = A Date in the format of CCYYMMDD (Date)
And
Service Date:
Loop 2400, DTP (Date – Service Date)
DTP01 = 472 (Date/Time Qualifier)
DTP02 = D8 (Date Time Period Format Qualifier)
DTP03 = Service Date in the format CCYYMMDD (Date Time Period) |
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