Medical Billing Forum

Billing => Facility Billing => Topic started by: sls on February 04, 2011, 01:34:03 PM

Title: can anyone with rej. from emdeon-i have no clue how to fix
Post by: sls on February 04, 2011, 01:34:03 PM
PAYER NAME/ID: BLUE SHIELD OF NJ    22099                                                                                           
ERROR MESSAGE: ADMISSION TYPE CODE: REQUIRED; MUST BE PRESENT ON INPATIENT                                                         
CLAIMS                                                                                                                             
FLD:         SEQ:     FIELD NAME:                  DATA IN ERROR:                                                                   
                                                                                                                                   
ERROR MESSAGE: ADMISSION SOURCE CODE: REQUIRED; MUST BE ENTERED ON INPATIENT                                                       
CLAIMS                                                                                                                             
FLD:         SEQ:     FIELD NAME:                  DATA IN ERROR:                                                                   
                                                                                                                                   
ERROR MESSAGE: ADMISSION DATE: REQUIRED; MUST BE ENTERED ON INPATIENT CLAIMS                                                       
FLD:         SEQ:     FIELD NAME:                  DATA IN ERROR:
Title: Re: can anyone with rej. from emdeon-i have no clue how to fix
Post by: Pay_My_Claims on February 04, 2011, 02:40:22 PM
Looks like you are trying to bill an inpatient claim and missing vital information

The admission type is needed (1 2 3,4) ( urgent, emergent, newborn or elective)

the admission source--via er, direct admit etc

and the admission date is needed
Title: Re: can anyone with rej. from emdeon-i have no clue how to fix
Post by: sls on February 04, 2011, 03:00:32 PM
we are billing for outpt rehab drug/alcohol .   the code we are using is 90853.  why would they think it is for inpt any ideas are welcome...
we can submit these claims on paper and get paid, but when we submit to emdeon this is the rejection code we get.
Title: Re: can anyone with rej. from emdeon-i have no clue how to fix
Post by: Michele on February 05, 2011, 06:15:06 PM
I would call Emdeon.  Sounds like a mapping issue.

Michele
Title: Re: can anyone with rej. from emdeon-i have no clue how to fix
Post by: Pay_My_Claims on February 06, 2011, 04:55:58 PM
we are billing for outpt rehab drug/alcohol .   the code we are using is 90853.  why would they think it is for inpt any ideas are welcome...
we can submit these claims on paper and get paid, but when we submit to emdeon this is the rejection code we get.

are you billing 90853 on the cms 1500 or the UB04?--is the insurance Cigna? They use that while others use the h0015

if you use the incorrect revenue code should be 906, if its outpatient facility for saiop services. then the scrubber in the software will reject the claim. if you are using a rev code that is set up for inpatient charges. or even the wrong type of bill code
Title: Re: can anyone with rej. from emdeon-i have no clue how to fix
Post by: rdmoore2003 on February 08, 2011, 11:55:05 AM
90853 is a therapy group code.  Is this what was rendered?  Check your POS.    But I agree, you may want to call emdeon.