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Edit 01194
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 2371 or 2375, which require the age of the client to be less than 65 years.
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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