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Edit 01206
Recipient Not In Care At Home Program – Invalid Rate Code Billed
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N30
HIPAA Healthcare Claim Status Code: 109
Entity Identifier Code: QC
Potential Causes:
The patient is not in the Care at Home program, but the Rate Code is for the Care at Home program.
Solution:
Check to ensure the proper Rate Code was entered. If the correct Rate Code was used then contact the Local Department of Social Services regarding the status of the patient as Care at Home.
| 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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