Error Message
At least one other status code is required to identify the inconsistent information.
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Description
This error appears as a rejection in the in the Electronic Module and is typically from an institutional claim. It means the claim was rejected because either the treatment code or room and board code is missing from the claim. Most payers require both codes be billed together on the same claim.
Two scenarios are possible:
- Both codes were billed on the same invoice, but they went on separate claims (most often the case). This can happen because an authorization has been attached to one code, but not the other.
- Only one of the codes was billed.
Resolution
If both codes were billed on the same invoice but went on separate claims.
- Go to the Clients Module.
- Double-click on the client line you would like to resolve.
- Click the Payers tab.
- Click on the Authorizations sub-tab.
- In the existing authorization line, in the Codes column, click on the picklist.
- Select both the treatment code and the room and board code.
- Click OK.
- Double the number of Max Units allowed.
- This will allow the authorization to accommodate both codes and will allow them to travel together on a claim.
- This will allow the authorization to accommodate both codes and will allow them to travel together on a claim.
- To resend the claim, go to the Electronic Module.
- Open the Invoice Window.
- Double click on the correct Date of Service (DOS) to open the Change Time Window.
- In the Authorization drop-down menu, select the authorization.
- Click Save.
- Do this for both the treatment and the room and board service lines.
- To resend, select both the treatment and the room and board service lines.
- Each line will be highlighted as you select them.
- Choose Resend at the bottom on the window.
- Assuming you do not get an error window, click on the data link in the Confirm Invoices window to verify both codes are on the same claim: X12 Summary
If only one code was billed, or the two codes went on separate invoices.
You will need to resubmit a new invoice with both codes attached.
- Go to the Time Module.
- Locate the client and both the treatment and room and board service lines for the DOS.
- Click on the DOS link.
- The Change Time Window will open.
- Change Invoiced drop-down to No.
- Click Save.
- Repeat the step for both service lines (treatment and room and board).
- Go to the Billing Module.
- Click Add.
- The Create New Invoices window will open.
- Use the filters in the Create New Invoices window to locate the client and DOS to bill.
- Bill the treatment and room and board codes out together on a new invoice.
- In this situation, be sure to write off the original invoice to provide the most accurate accounting information from the Payments Module. The original invoice that denied will have two bill lines.