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Appendix Q-Inpatient Edit Program Error Codes

X12-837 CODE OLD UDS CODE DESCRIPTION
2000HL2000 SUBSCRIBER NOT FOUND
2000HL3000 HL INFORMATION SOURCE CODE
2000HL4000 HL CHILD CODE
2000NM19000 30005 PAYER ID - PRIMARY PAYER
2000SBR0000 SBR SEGMENT NOT FOUND
2000SBR9000 30004 CLAIM FILING INDICATOR CODE - PRIMARY PAYER
2010DMG2000 20008 DATE OF BIRTH
2010DMG3000 20007 GENDER
2010N31000 25019 STREET ADDRESS
2010N41000 25021 CITY
2010N42000 25023 STATE
2010N43000 25024 ZIP CODE
2010N46000 25022 COUNTY CODE
2010REF2000 25029 UNIQUE ID CODE
2300CLM0000 INVALID SUBSCRIBER/PATIENT
2300CLM1000 20003 PATIENT CONTROL NUMBER
2300CLM2000 90013, 90015 TOTAL CHARGES FOR CLAIM
2300CLM5000 40004 TYPE OF BILL CODE
2300CL11000 20010 ADMISSION TYPE CODE
2300CL12000 20011 ADMISSION SOURCE CODE
2300CL13000 25009 PATIENT STATUS CODE
2300DTP3000 20022 DISCHARGE HOUR
2300DTP3001 20019 - 20020 STATEMENT COVERS PERIOD
2300DTP3002 20017 - 20018 ADMISSION DATE AND HOUR
2300HI1000 70004 PRINCIPAL DIAGNOSIS CODE
2300HI1001 70005 OTHER DIAGNOSIS CODE
2300HI1002 79010 PRESENT ON ADMISSION INDICATOR
2300HI1003 70013 PRINCIPAL PROCEDURE CODE
2300HI1004 70014 PRINCIPAL PROCEDURE DATE
2300HI1005 70015 OTHER PROCEDURE CODE
2300HI1006 70016 OTHER PROCEDURE DATE
2300HI1007 40023 OCCURRENCE SPAN FROM
2300HI1008 40024 OCCURRENCE SPAN THROUGH
2300HI1009 40009 OCCURRENCE DATE
2300HI1010 41017 VALUE AMOUNT
2300HI1011 25007 NEWBORN BIRTH WEIGHT
2300HI2000 70025 ADMITTING DIAGNOSIS CODE
2300HI3000 70026 CAUSE OF INJURY E-CODE
2300HI4000 79039 PLACE OF INJURY E-CODE
2300NM19000 30005 PAYER ID - OTHER PAYER
2300NTE2000 25013 RACE CODE
2300NTE2001 25014 ETHNICITY CODE
2300NTE2002 25016 EXPECTED PRIMARY SOURCE OF REIMBURSEMENT
2300NTE2003 25017 EXPECTED SOURCE OF REIMBURSEMENT - OTHER 1
2300NTE2004 25018 EXPECTED SOURCE OF REIMBURSEMENT - OTHER 2
2300NTE2005 79024 METHOD OF ANESTHESIA
2300NTE2006 79042 EXEMPT UNIT INDICATOR
2300NTE2007 AMI - HEART RATE
2300NTE2008 AMI - SYSTOLIC BLOOD PRESSURE
2300NTE2009 AMI - DIASTOLIC BLOOD PRESSURE
2300NTE2011 SOURCE OF PAYMENT TYPOLOGY I
2300NTE2012 SOURCE OF PAYMENT TYPOLOGY II
2300NTE2013 SOURCE OF PAYMENT TYPOLOGY III
2300QTY2000 30020 COVERED DAYS
2300QTY2001 30021 NON-COVERED DAYS
2300REF2000 20025 MEDICAL RECORD NUMBER
2300REF2001 25011 MOTHERS MEDICAL RECORD NUMBER
2300REF2002 8005A ATTENDING PHYSICIAN ID NUMBER
2300REF2003 8006A OPERATING PHYSICIAN ID NUMBER
2300REF2004 8007A OTHER PHYSICIAN ID NUMBER
2300SBR9000 30004 CLAIM FILING INDICATOR CODE - OTHER PAYER
2400SV21000 50004 ACCOMMODATION CODE
2400SV21001 60004 ANCILLARY CODE
2400SV23000 50007 ACCOMMODATION CHARGES
2400SV23001 60009 ANCILLARY CHARGES
2400SV25000 50006 ACCOMMODATION DAYS
2400SV26000 50005 ACCOMMODATION RATE
2400SV27000 50008 ACCOMMODATION NON-COVERED CHARGES
2400SV27001 60010 ANCILLARY NON-COVERED CHARGES
M0001 M0001 INCOMPATIBLE DIAGNOSIS CODE AND COMPUTED PATIENT AGE
M0002 M0002 INCOMPATIBLE DIAGNOSIS CODE AND PATIENT SEX
M0003 M0003 INCOMPATIBLE PROCEDURE CODE AND PATIENT SEX
M0004 M0004 ACCOMMODATION DAYS * RATE DOES NOT EQUAL TOTAL CHARGE
M0005 M0005 ACCOMMODATION DAYS EXCEED LENGTH OF STAY
M0006 M0006 ACCOMMODATION NON-COVERED CHARGES EXCEED TOTAL-CHARGES
M0007 M0007 ANCILLARY NON-COVERED CHARGES EXCEED TOTAL CHARGES
M0012 M0012 INCOMPATIBLE PATIENT ZIP CODE AND COUNTY CODE
M0014 M0014 INCOMPATIBLE/INCOMPLETE ACCOMMODATION INFORMATION
M0015 M0015 INCOMPATIBLE/INCOMPLETE ANCILLARY INFORMATION
M0017 M0017 DATE OF ADMISSION PRIOR TO PATIENT DATE OF BIRTH
M0018 M0018 STATEMENT FROM DATE NOT EQUAL ADMISSION DATE
M0019 M0019 STATEMENT THRU DATE PRIOR TO ADMISSION DATE
M0023 M0023 INCOMPATIBLE NEWBORN BIRTH WEIGHT AND CALCULATED AGE
M0025 M0025 INCOMPATIBLE NEWBORN DIAGNOSIS AND MOTHERS MED REC NUMBER
M0026 M0026 INCOMPATIBLE PATIENT STATE AND COUNTY CODE
M0027 M0027 INCOMPATIBLE PATIENT STATE AND POSTAL ZIP CODE
M0030 M0030 ALTERNATE CARE DAYS EXCEED LENGTH OF STAY
M0031 M0031 LEAVE OF ABSENCE DAYS EXCEED LENGTH OF STAY
M0032 M0032 INCOMPATIBLE OCCURRENCE CODE AND OCCURRENCE DATE
M0033 M0033 INCOMPATIBLE VALUE CODE AND VALUE AMOUNT
M0035 M0035 PROCEDURE DATE NOT WITHIN PATIENT STAY DATES
M0037 M0037 INCOMPATIBLE EXTERNAL CAUSE AND PLACE OF INJURY E-CODE
M0038 M0038 INCOMPATIBLE OPERATING DATA (PROCEDURE, DATE, AND PHYSICIAN ID
M0039 M0039 INCOMPATIBLE DIAGNOSIS CODE AND CAUSE OF INJURY E-CODE
M0040 M0040 DATE OF ADMISSION PRIOR TO FACILITY OPEN DATE
M0041 M0041 THROUGH DATE EXCEEDS FACILITY CLOSE DATE
M0042 M0042 NO VALID CHARGES FOUND FOR PATIENT
M0044 M0044 INCOMPATIBLE/INCOMPLETE PAYER INFORMATION
M0045 M0045 COVERED + NON-COVERED DAYS EXCEEDS LENGTH OF STAY
M0047 M0047 INCOMPATIBLE NEWBORN ADMIT TYPE AND ADMIT SOURCE
M0048 M0048 DUPLICATE SUBMISSION
M0050 M0050 INVALID CALCULATED AGE
M0051 M0051 INCOMPATIBLE NEWBORN BIRTHWEIGHT AND LENGTH OF STAY
M0052 M0052 PRINCIPAL DIAGNOSIS INVALID WITHOUT SECONDARY DIAGNOSIS
M0053 M0053 INCOMPATIBLE/INCOMPLETE OCCURRENCE SPAN INFORMATION
M0054 M0054 OCCURRENCE SPAN NOT WITHIN PATIENT STAY DATES
M0055 COMPUTED CHARGES NOT EQUAL REPORTED TOTAL CHARGES
M0056 REQUIRED FIELDS FOR AMI CASE NOT REPORTED
M0057 MORE THAN 200 ANCILLARIES REPORTED
M0058 MORE THAN 30 NON-ACUTE CARE SPANS REPORTED
M0059 MORE THAN 50 ACCOMMODATIONS REPORTED

INPATIENT EDIT PROGRAM WARNING CODES
W0001 W0001 INCOMPATIBLE DIAGNOSIS CODE AND COMPUTED PATIENT AGE
W0002 W0002 PROCEDURE DATE WITHIN 3 DAYS PRIOR TO ADMIT DATE
W0003 INVALID SOURCE OF PAYMENT TYPOLOGY I
W0003A MISSING SOURCE OF PAYMENT TYPOLOGY I
W0004 SOURCE OF PAYMENT TYPOLOGY II
W0005 SOURCE OF PAYMENT TYPOLOGY III
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