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Edit 01034
Specialty Code Invalid for Long Term HHC
HIPAA Claim Adjustment Reason Code: 170
Remark Code: N/A
HIPAA Healthcare Claim Status Code: 145
Entity Identifier Code: 1Z
Potential Causes:
The Rate Code on the claim is for Long Term Home Health Care and the Specialty Code for Long Term Home Care (798) is not on the Provider Master File or is end dated.
Solution:
Check the Rate Code entered on the claim to ensure the correct Rate Code was entered. If billing for Long Term Home Health Care, the Specialty Code 798 must be on the Provider Master File and be in an active status. To check on the Specialty Code call Provider Services. If the Specialty Code is not present on the file or is end dated, call the Department of Health Enrollment Unit.
| 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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