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Edit 01022
Therapeutic Leave Days not Separate
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N63
HIPAA Healthcare Claim Status Code: 456
Entity Identifier Code: 7C
Potential Causes:
The claim is for Therapeutic Leave Days and the number of Therapeutic Days was not reported
correctly..
Solution:
The Patient Status Code (revenue Code 0183) must reflect Therapeutic Leave and the number of days must be entered in both Total Medicaid Days and as Therapeutic Leave Days in the SV Segment of the 2400 loop. Enter the data in the loop and the segment provided, and resubmit.
Note: For more information on Therapeutic/Hospital Days, please refer to Section 3., Revenue Codes in the 837 Institutional Supplemental Companion Guide on this site (www.nyhipaadesk.com).
| 837 Institutional |
Loop 2300, DTP (Statement Dates)
DTP01 = 434 (Date/Time Qualifier)
DTP02 = D8 or RD8 (Date Time Period Qualifier)
DTP03 = Format CCYYMMDD or CCYYMMDD-CCYYMMDD (Date Time Period)
And
Loop 2400, SV2 (Institutional Service Line)
SV201 = 0183 (Service Line Revenue Code -If applicable for Patient Status code)
SV202-1 = HC (Product/Service ID Qualifier)
SV202-2 = Procedure Code – Enter HCPCS procedure code (Product/Service ID)
SV204 = DA
SV205 = Number of Days |
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