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Edit / Error Knowledge Base > Select Edit Range > 01001 to 01100 >

 

 

Edit 01028

Rate Code Invalid for CMCM/MSC Category of Service

HIPAA Claim Adjustment Reason Code: B7
    Remark Code: M49
HIPAA Healthcare Claim Status Code: 463
    Entity Identifier Code: N/A

Potential Causes:
The Rate Code on the claim is invalid for the Category of Service assigned to the claim.

Solution:
Ensure the Rate Code on the claim is correct for the service billed.

837 Institutional
Loop 2300, HI (Value Information) - (Inpatient of Clinic)
HI01-1 = BE (Value)
HI01-2 = 24 (Value Code)
HI01-5 = four digit Rate Code (monetary amount)


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