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Edit 01342
P.T. Clinic Rate Billed/Provider P. T. Clinic Number Missing
HIPAA Claim Adjustment Reason Code: B7
Remark Code:
N259
HIPAA Healthcare Claim Status Code: 142
Entity Identifier Code: 1P
Potential Causes:
The Provider is billing with a Part Time Clinic Rate Code but the 13-digit Part Time Clinic Certification Number is missing from the claim.
Solution:
The Provider needs to enter the 13-digit Part Time Clinic Certification Number in the REF02 field in Loop 2010AA. The Provider should also ensure that the Rate Code is correct as well. (If the Rate Code is incorrect, then the Provider needs to correct the Rate Code and re-bill.) Please enter the data in the loops and segments provided.
| 837 Institutional |
| Loop 2010AA (Billing Provider Secondary Identification)
REF01 = 1J (Facility ID Number) (Reference Identification Qualifier)
REF02 = Part Time Clinic Certification Number (Billing Provider Additional Identifier)
Loop 2300, HI (Value Information)
HI01-1 = BE (Code List Qualifier Code)
HI01-2 = 24 (Value Code)
HI01-5 = 4 Digit Rate Code (Value Code Associated Amount)
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