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BCBS: (A3) Missing or invalid information. (21)

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Papillon DeBoer

Hi! I'm new to billing and am still figuring out claim rejections. Any sense of what this code means? If it's referring to box 21, that's diagnosis, and I have F43.21 (adjustment disorder with depression) which other folks tell me they use frequently with BCBS. Any thoughts? Thank you!

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14 comments

Date Votes
  • Molly Biondo

    I have the same exact problem and same exact dx.  I would love to know if it's a common error today.

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  • Papillon DeBoer

    Hi Molly, I haven't been able to find any more info on this, so I just resubmitted without editing. It's a valid diagnosis that other clinicians get approved. I'll post here when I get a response.

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  • Papillon DeBoer

    Well it got rejected again within 3 hours. I've asked on a forum to see if anyone else is getting this.

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  • Molly Biondo

    Thanks for letting me know.  That's so crazy!  

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  • Papillon DeBoer

    Hi Molly, I think I found the answer. The client hadn't chosen their state in the address section, and I didn't see that it was missing. Feeling kinda dumb here. :D Check all that info with a magnifying glass; it must be random that we have the same diagnosis.

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  • Ruth
    • Edited

    Hi Molly and Papillion,

    Turns out you were both experiencing claim rejections because your client's State wasn't indicated on the claim, just like Pappillion suspected! Please add this information to your client's address from their file > Edit > Client Info tab. You can then delete the previously created claim and regenerate it and submit it. Molly, my colleague Sarah has emailed you with further instructions, let her know if you're still unable to successfully submit a claim for this client. 

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  • Papillon DeBoer

    Thanks Ruth! A little embarrassed here, new to billing. I will go over the next rejection a little more carefully, all the tiny boxes. :D

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  • Jason Klarer

    You guys/gals rock, thank you. Just saved me some frustration...

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  • Kimberly Wilson

    I am having the same error, but diagnosis are correct and state is in there.  I cannot find any errors in the claim but all of my claims this week are being rejected for the same reason.

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  • Amy Herrold, MS, LPC

    I am with Kimberly!  Help!!

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  • Tiffany Robledo, M.S., CCC-SLP

    I also have this error and its not due to address or diagnosis.  One hint when looking at remittance advice said "missing payment"

     

    Otherwise, I have no idea what is missing.  Help!  I have 3 months of claims in error for a single patient, all other claims are going through fine.

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  • Carmen L. Lucia

    Having the same problem as Tiffany. Diagnosis is fine, state is in there. Claim rejected multiple times. Also have "missing payment" message next to the claim in the billing area of the client's profile. I'm now behind four months on her billing. I have a few BCBS clients for whom I cannot get the claims through. Many other BCBS client claims going through fine. So frustrating. 

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  • Deborah Hartze

    Hi all, just had the same issue, never happened before; but weirdly enough my Dx codes were the same as above (the adjustment disorder with depression, plus MDD recurrent).  Everything else is filled in, and I have checked client's eligibility on web page and he is good to go.???  Is this a rejection from the clearinghouse or the insurance company.  My client has Blue Cross/Blue Sheild but is a Teamster and still asks me to use local payer ID which is WABLC here in Washington state.

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  • Ruth

    Hi Everyone, our Insurance Team is ready to help resolve any claim rejection issues! They'll be able to look into your account and open an investigation with our clearinghouse if necessary. Please reach out to them by clicking on the ? icon in your account > Get Help > No > Contact Support > Send an Email Request! Here's more on how to email us for further investigation: https://support.simplepractice.com/hc/en-us/articles/360002795252

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