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Edit 01163
Technical Component not appropriate for Practitioner Claim
HIPAA Claim Adjustment Reason Code: 4
Remark Code: N/A
HIPAA Healthcare Claim Status Code: 453
Entity Identifier Code: N/A
Potential Causes:
The Procedure Code entered was for Physician Services and the Modifier TC (Technical Component) was entered on the claim. The use of the TC Modifier is limited to the Hospital/Clinic claim and cannot be used on the Physician claim for professional services.
Solution:
Remove the Technical Component (TC) modifier from the claim. Enter the data in the loop and the segment provided, and resubmit.
| 837 Professional |
Loop 2400, SV1 (Professional Service)
SV101-3 = Procedure Modifier – Enter HCPCS procedure code modifier
SV101-4 = Procedure Modifier – Enter HCPCS procedure code modifier
SV101-5 = Procedure Modifier – Enter HCPCS procedure code modifier
SV101-6 = Procedure Modifier – Enter HCPCS procedure code modifier |
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