Payer Rejection: SUB-ELEMENT SV101-07 IS MISSING

Payer Rejection: SUB-ELEMENT SV101-07 IS MISSING

PE SUB-ELEMENT SV101-07 IS MISSING. 

IT IS REQUIRED WHEN PROCEDURE CODE IS NON-SPECIFIC (SV101-02 IS J3301). SEGMENT SV1 IS DEFINED IN THE GUIDELINE AT POSITION 3.

  • The non-specific Procedure Code needs a more detailed description.

Resolution: Add a detailed description in the Note Field on the line item.

  • According to EDI, they move the info to the correct place

  • NOC (Not Otherwise Classified) codes need a description by medicare standards.

  • Some Medicare replacements also require this.

  • This is sent in 2410 Loop.