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Back  RFI # 160: Invalid/Missing Rejection Code

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Submitter

Angela Hendrix

Description

2010C/2010D AAA04 Required if AAA03 is present and indicates that the rejection is due to invalid or missing dependent or patient data. Which codes are not included as missing/invalid? Some code descriptions explicitly state they are invalid/missing, and most/all other codes can be logically inferred as invalid data.

Response

AAA04 is required when AAA03 is present and indicates that the rejection is due to invalid or missing subscriber or patient data. The following codes would require the presence of the AAA04
15 Required application data missing
58 I/M Date-of-Birth
64 I/M Patient ID
65 I/M Patient Name
66 I/M Patient Gender Code
72 I/M Sub/Insured ID
73 I/M Sub/Insured Name
74 I/M Sub/Insured Gender Code
79 Invalid Participant ID
For all other AAA03 values, use of the AAA04 is at the sender's discretion.
Submission 12/2/2004
Status Date 1/6/2005
Status F - Final
Primary References
Document 004010X094A1
SectionDetail
Page268
Set ID278
Table2
Loop2010
Segment Position230
Segment IDAAA
Element Position04
External Code List901