ANSI Claim Rejections Examples
ANSI Claim Rejections occur at multiple locations within the electronic EDI claim. Suppliers are strongly encouraged to review all aspects of a claim denial. Find below top 10 ANSI Claim Rejections.
- X223.423.2400. LX01.030 – This Claim is rejected for the Service line number greater than maximum allowable for payer. 2400.LX01 must be > 0 and <= 449
- X223.090. 2010AA.REF02.050 This Claim is rejected for a relational field in error within the Billing Provider’s National Provider Identifier (NPI) and Billing Provider’s Tax ID. 2010AA.REF must be associated with the provider identified in 2010AA.NM109
- X223.424.2400. SV202-2.020 This Claim is rejected for Invalid Information within the HCPCS. When 2400.SV202-1 = “HC”, 2400.SV202-2 must be a valid HCPCS Code
- X223.424.2400. SV202-7.025 CSCC A8: “Acknowledgement / Rejected for relational field in error”CSC 306 Detailed description of service 2400.SV202-7 must be present. when 2400.SV202-2 contains a non-specific procedure code
- X999.DUPE Rejected due to duplicate ST/SE submission The ST/SE (Batch number) is the same within the file. The Batch numbers must be unique within each file submitted
- X223.153.2300. CL103.015 This Claim is rejected for Invalid Information with the Patient discharge status. Verify the Patient’s Discharge status is sent on the claim when the value in the 2300 CL103 is “20”, “40” or “42”, at least one occurrence of 2300.HI01-2 thru HI12-2 must= “55” where HI01-1 is “BH”
- X223.345. 2310E.N403.030 This Claim is rejected for Invalid Information within the Service Location’s Postal/Zip Code. Verify Postal/Zip Codes for the Service Location on the USPS website prior to submitting claims
- X223.112. 2010BA.NM109.020 This Claim is rejected for containing Invalid Information within the Subscriber’s contract/ member number. The subscriber HICN is invalid. Verify the HICN is entered exactly as it appears on the beneficiary’s red, white, and blue Medicare card. Medicare number can only be 10 to 11 characters only. Here are the valid formats: NNNNNNNNNA or NNNNNNNNNAA or NNNNNNNNNAN. If MBI: 2010BA.NM109 must be 11 positions in the format of C A AN N A AN N A A N N , where “C” represents a constrained numeric 1 thru 9, “A” represents alphabetic character A-Z but excluding S, L, I, O, B, Z, “N” represents numeric 0 thru 9 and “AN” represents “A” or “N”. If the patient’s Medicare number is not in these formats, your claim will reject
- X223.387. 2330B.N403.030 This Claim is rejected for Invalid Information within the Other payer’s Explanation of Benefits/payment information’s Postal/Zip Code. 2330B.N403 must be a valid US zip code when N404 is US or blank. Verify Postal/Zip Codes for the Other Payer on the USPS website prior to submitting claims
- X223.143.2300. CLM02.080 This Claim is rejected due to the Claim being out of Balance within the Payer’s payment information. CLM02 must = the sum of all 2320 CAS amounts & all 2430 CAS amounts and the 2320 AMT02 (when AMT01=D) for each other payer occurrence.