|
Edit 01169
Procedure Requires the Appropriate Component Modifier
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 on the claim requires a modifier and no modifier was present.
Solution:
Check the Procedure Code to ensure the correct Procedure Code was entered. If the correct Procedure Code was entered, then the appropriate modifier must also be entered. Enter the data in the loop and the segments provided, and resubmit.
| 837 Institutional |
Loop 2400, SV2 (Institutional Service Line) - (Non-Inpatient)
SV202-1 = HC (Product/Service ID Qualifier)
SV202-2 = Procedure Code – Enter HCPCS procedure code (Product/Service ID) |
| 837 Professional |
Loop 2400, SV1 (Professional Service)
SV101-1 = HC (Product/Service ID Qualifier)
SV101-2 = Procedure Code (Product/Service ID) |
|
