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Georgia Medicare Part A
Top Five EDI Claim Rejections for August 2009

Audit trails show which of your claims were accepted by the Cahaba GBA Part A processing system, along with claims that were rejected and the reason for the rejection.  Referring to this report will allow you to correct and resubmit claims quickly, resulting in a dramatically reduced turnaround time.  You will also become aware of any major problems with your claims so they can be corrected before they create an interruption in your cash flow.  Audit trail reports are available the next business day for files that are received before 3:30 p.m. Central Time.  If you are not receiving your audit trails contact your software vendor, billing service, or clearing house.

See Audit Trail Explanations for a more complete list of edits, along with descriptions of loops that might be referenced in an edit.

In order to increase the number of claims that successfully pass through audit trails and into processing Cahaba GBA Part A EDI Services is providing you with the top five reasons for claim rejections.  For the month of August 2009, these are:

Claim Rejection Description Number of Claims
888 INSTREAM REJECTION
There was a problem involving HIPAA required loops, segments, or values.  The specific loop will be identified, for example, 'ELEMENT N401 (D.E. 19) AT COL. 4 IS MISSING, THOUGH MARKED "MUST BE USED" (LOOP:2010BA POS:3140)'.  The number after 'POS' indicates the position in the file where the error occurred.  		2,658
777 APASS MODULE REJECTION
An undefined error has occurred.  Contact EDI Services at (866) 582-3253 for more information		 911
355 INV CLM FILING IND FOR MSP VAL CD (XX)
The Claim Filing Indicator for this Medicare Secondary Payer (MSP) claim was invalid for the Value Code used.  The Value Code will appear inside the parenthesis.		 612
351 VAL AMT 44 MUST BE > 0 & < TOT CHG
Value amount 44 was submitted and was either equal to zero or equal to or greater than the total charge.		 245
333 INVALID PAT STATUS FOR TYPE BILL
The patient’s status was invalid for the type of bill submitted.		 187

 

Page last updated: September 10, 2009

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