Home » Important edit changes for Professional claims effective April 4, 2015

Important edit changes for Professional claims effective April 4, 2015

CMS issued Change Request (CR) 8851 edit spreadsheet changes for Professional electronic claims. The Professional edit changes below will be implemented the morning of April 4, 2015.

NEW EDITS

  • X222.226.2300.HI01-2.130 — 277CA edit added to reject claims if the diagnosis code is duplicated within the HI segment
  • X222.239.2300.HI01-2.030 — 277CA edit added to reject claims if the Anesthesia Related Surgical Procedure code is duplicated within the HI segment
  • X222.242.2300.HI01-2.030 — 277CA edit added to reject claims if the Condition codes are duplicated within the HI segment
  • X222.351.2400.SV101-3.030 — 277CA edit added to reject claims if the Modifier codes are duplicated within the same SV1 segment
  • X222.480.2430.SVD03-3.020 — 277CA edit added to reject claims if the Modifier codes are duplicated within the same SVD segment

EDI Services
1-877-235-8073 (JL)
1-855-252-8782 (JH)

Reference: www.novitas-solutions.com

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