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Appendix R-Outpatient 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
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
2300HI1009 40009 OCCURRENCE DATE
2300HI1010 41017 VALUE AMOUNT
2300HI2000 70025 REASON FOR VISIT
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
2300NTE2005 79024 METHOD OF ANESTHESIA
2300NTE2007 AMI - HEART RATE
2300NTE2008 AMI - SYSTOLIC BLOOD PRESSURE
2300NTE2009 AMI - DIASTOLIC BLOOD PRESSURE
2300NTE2010 INVALID PROCEDURE TIME IN NTE
2300NTE2011 SOURCE OF PAYMENT TYPOLOGY I
2300NTE2012 SOURCE OF PAYMENT TYPOLOGY II
2300NTE2013 SOURCE OF PAYMENT TYPOLOGY III
2300REF2000 20025 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 60004 ANCILLARY CODE
2400SV22000 60005 CPT4/HCPCS CODE
2400SV22001 60006 CPT4/HCPCS Modifier - 1
2400SV22002 60007 CPT4/HCPCS Modifier - 2
2400SV23000 60010 ANCILLARY CHARGES
2400SV27001 60011 ANCILLARY NON-COVERED CHARGES
M0001 M0001 INCOMPATIBLE DIAGNOSIS CODE AND COMPUTED PATIENT AGE
M0002 M0002 INCOMPATIBLE DIAGNOSIS CODE AND PATIENT SEX
M0007 M0007 ANCILLARY NON-COVERED CHARGES EXCEED TOTAL CHARGES
M0012 M0012 INCOMPATIBLE PATIENT ZIP CODE AND COUNTY CODE
M0015 M0015 INCOMPATIBLE/INCOMPLETE ANCILLARY INFORMATION
M0017 M0017 DATE OF ADMISSION PRIOR TO PATIENT DATE OF BIRTH
M0019 M0019 STATEMENT THRU DATE PRIOR TO ADMISSION DATE
M0026 M0026 INCOMPATIBLE PATIENT STATE AND COUNTY CODE
M0027 M0027 INCOMPATIBLE PATIENT STATE AND POSTAL ZIP CODE
M0032 M0032 INCOMPATIBLE OCCURRENCE CODE AND OCCURRENCE DATE
M0033 M0033 INCOMPATIBLE VALUE CODE AND VALUE AMOUNT
M0037 M0037 INCOMPATIBLE CAUSE AND PLACE OF INJURY E-CODE
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
M0048 M0048 DUPLICATE SUBMISSION
M0050 M0050 INVALID CALCULATED AGE
M0052 M0052 PRINCIPAL DIAGNOSIS INVALID WITHOUT SECONDARY DIAGNOSIS
M0055 COMPUTED CHARGES NOT EQUAL REPORTED TOTAL CHARGES
M0056 REQUIRED FIELDS FOR AMI CASE NOT REPORTED
M0057 MORE THAN 200 ANCILLARIES REPORTED
M0101 INVALID AMOUNT FOR OPERATING TIME - VALUE CODE 83
M0102 REQUIRED PROCEDURE TIME FOR AMB SURG NOT FOUND
M0103 INCOMPATIBLE OPERATING TIME AND PROCEDURE CODE
M0105 INVALID LENGTH OF STAY - AMB/SURG > 3 OR ED > 4 DAYS
M0106 INVALID AMOUNT FOR ACCIDENT HOUR - VALUE CODE 45
OUTPATIENT EDIT PROGRAM WARNING CODES
W0001 W0001 INCOMPATIBLE DIAGNOSIS CODE AND COMPUTED PATIENT AGE
W0002 W0002 SOURCE OF PAYMENT TYPOLOGY
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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