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How do I resolve this claim rejection?

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15 comments

  • Candee Sharp

    I just received this message as well hoping you receive an answer

     

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  • Sara

    Hi everyone,

    Please create a Help Request so that our Customer Success Team can look into this for you and offer assistance. Click on the ? icon in your account > Ask Questions > No > Contact Support > Send an Email Request.

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  • Candee Sharp

    I did, thank you for explaining the procedure though just waiting for answer

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  • ELLECIA DECOUTEAU

    What is the solution? I have received this message too.  

    VALUE OF SUB-ELEMENT HEALTH CARE CODE INFORMATION-02 IS INCORRECT. EXPECTED VALUE IS FROM EXTERNAL CODE LIST - ICD-10-CM DIAGNOSIS CODE (897) WHEN HEALTH CARE CODE INFORMATION-01='ABK'. HEALTH CARE INFORMATION CODES IS DEFINED IN THE GUIDELINE AT POSITION 2310. (A3 - 21)

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  • Candee Sharp

    Its all about the diagnosis code being used make sure it is an ICD-10

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  • Jessica Sarabale

    Is it enough to change it on the treatment plan since the diagnosis won't be retroactively changed on the progress note? And there's no way that I can see to edit it on the progress note. 

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  • Kurt Weakland

    Oh jeeesh, can we just get some direction on this without a ticket? 

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  • Candee Sharp

    Hi Kurt I found that the ICD code was not an ICD 10 code and needed to updated to one

     

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  • Stacy Choi

    I'm wondering if Simple Practice needs to update to ICD 10 codes? Because mine are coming back rejected for this reason.

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  • Layna Lankford

    I have gotten this error and am using Simple Practice's code which is frustrating. I don't know what to change it to.

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  • Stacy Choi

    I think Simple Practice needs to update it in their system. I have just looked up online the ICD10 code and changed it but it is quite frustrating. It seems like there are more that are coming back rejected recently due to invalid diagnosis code.

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  • Felita Hannah, MA

    What is the solution? I have received this rejection.

    Missing or invalid information. VALUE OF SUB-ELEMENT HEALTH CARE CODE INFORMATION-02 IS INCORRECT. EXPECTED VALUE IS FROM EXTERNAL CODE LIST - ICD-10-CM DIAGNOSIS CODE (897) WHEN HEALTH CARE CODE INFORMATION-01='ABF'. HEALTH CARE INFORMATION CODES IS DEFINED IN THE GUIDELINE AT POSITION 2310. (A3 - 21)

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  • SUZANNE HODGKINS

    Agree.  We have several people asking the same thing.  Can't we get some direction without a ticket? 

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  • SUZANNE HODGKINS

    I just wanted to hop on and say that the support email was helpful.  They identified that I used R62.5 instead of R62.50,  and R62.5 is not billable.  I would never have caught that, and I reviewed the codes several times.  So, yes, this rejection notice means that an ICD 10 code is not billable.  What I was told to do was to fix it in the POC, lock and save.  Download a copy of the rejected claim for my records.  Delete the rejected claim.  Submit a new one - but check that the code is correct this time.  And Bob's your uncle...the claim was paid in 24 hours.  I hope this helps.  

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  • Caprisheus Oliver

    I received this rejection code and it is filed exactly like a previously paid claim for same client and provider:

    • Missing or invalid information. VALUE OF SUB-ELEMENT HEALTH CARE CODE INFORMATION-02 IS INCORRECT. EXPECTED VALUE IS FROM EXTERNAL CODE LIST - ICD-10-CM DIAGNOSIS CODE (897) WHEN HEALTH CARE CODE INFORMATION-01='ABF'. HEALTH CARE INFORMATION CODES IS DEFINED IN THE GUIDELINE AT POSITION 2310.
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