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Edit 01193
Rate Code Invalid For Client Age
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N129
HIPAA Healthcare Claim Status Code: N/A
Entity Identifier Code: N/A
Potential Causes:
The rate code on the claim is 2370 or 2374, which require the age of the client to be less than 18 years or greater than 64.
Solution:
Check the rate code to ensure the correct one was entered. If the rate code is correct then, using the MEVS system, check the age of the client. If the date of birth is incorrect, contact the LDSS (Local District Social Services Office).
| 837 Institutional |
Loop 2300, HI (Value Information)
HI01-1 = BE (Code List Qualifier Code)
HI01-2 = 24 (Industry Code)
HI01-5 = 4 Digit Rate Code (Monetary Amount)
- and -
DMG (Subscriber Demographics)
DMG02 (Subscriber Birth Date)
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