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Edit 01029
Required PA for Rate Code Not Found
HIPAA Claim Adjustment Reason Code: 197
Remark Code: N/A
HIPAA Healthcare Claim Status Code: 252
Entity Identifier Code: N/A
Potential Causes:
The claim requires a Prior Approval and there was no Prior Approval on the claim.
Solution:
Enter the required Prior Approval in the loop/segment as provided below.
| 837 Institutional |
Loop 2300, REF (Prior Authorization or Referral Number)
REF01 = G1 (Prior Authorization Number)
REF02 = Prior Authorization Number
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