Intellect TM

999 Errors and Solutions

(02/2012)

As of 02-02-2012, edits have been organized by loop number and clearinghouse.
New additions continue to show the date they were added.

Table of Contents: ShowHide

CTX*SITUATIONAL TRIGGER*NM1

Solution: This indicates that your Group NPI and Individual NPI is the same. Go to Utility/Provider and set the <Group Y/N> field to N. Correct this as follows: 

* Intellect (Windows version): Go to Utility/Provider and set the <Group Y/N> field to N.

* OnStaff (Unix version): Go to Utility/Provider and set the <Box24K(Y/N)> field to N.   

IK3 2010:

IK3*N4*11111*2010*8

Solution: This is related to the Zip code. Check all of your zip codes related to the charges/claim.

IK3 2310:

Added 02-02-2012

Solution: Verify the referring’s NPI against the bad one listed, xxxxxxxxx. Turns out the last digit was wrong.

IK3-PRV-2310

Solution: When the IK4 is populated with the Taxonomy Code, update the system to the latest version.

IK3-SITUATIONAL TRIGGER-NM1-2310

Solution: This rejection is related to the referring provider information. Because of the different type of billings, please contact Medicare directly for direction.

IK3 2310 + CTX SITUATIONAL TRIGGER 2010:

Added 02-02-2012

Solution:

* INTELLECT:

If /Provider/<Group NPI>  =<NPI> set <Group Provider(Y/N)>=N
If /Provider/<Group NPI>^=<NPI> set <Group Provider(Y/N)>=Y

* UNIX:

If /Provider/<Group NPI>   =<NPI> set <HCFA Box 24K(Y/N)>=N
If /Provider/<Group NPI>^=<NPI> set <HCFA Box 24K(Y/N)>=Y

LOOP 2310 NM1 IMPLEMENTATION DEPENDENT NOT USED SEGMENT

Added 07-09-2012

Solution: This message is due to a Referring doctor that is not necessary for a particular claim. Medicare is a lot more strict as to whether a Referring Provider is needed or not.
In Intellect, remove the Referring doctor and re-transmit the claim.  

IK3 2320:

CTX*SITUATIONAL TRIGGER***2320 IK3*SBR*55*2320*8

Solution: For Intellect, make sure the Claim Filing Indicator is set to the proper value in the Utility/Insurance table.
Note: When you receive this message, your claims are NOT accepted.

IK3-SBR-2320 Situational Trigger

Solution: This issue can be related to several items. We suggest the following:
Go to Patient Demographics and check Insurance Information as follows:

* Subscriber Number must be a valid Sub ID and Group Number must be a valid Group number (this is especially true for the MEDI-MEDI patients).

* Status field must be blank.   

Added 01-19-2012

IK3*SBR*line#*2320*8

CTX*CLM01:acct#

IK4*3**1

Solution: This is related to the COBA/OCNA Codes. Go to  www.cms.gov/cobagreement/downloads/contacts.pdf and get the 'Identification Number' for the payor.   

* For Unix: Go to Utility/Insurance and populate the <COBA>, <Payor & Office Code>, <Receiver Code>, <GS03>, and <Eligibility Receiver> fields with the 'Identification Number'.

* For Intellect: Go to Utility/Insurance and populate the <COBA>, <Payor & Office Code>, <Receiver>, and <Payer Identifier> fields with the 'Identification Number'.  

IK3 2320 + IK3 2330:

Added 02-02-2012

Solution:

* UNIX –

1) Patient had two ‘T’ertiary insurances.  Client may only have one each of Primary, Secondary, &/or Tertiary.

2) Secondary and Tertiary insurances need /Ins/<COBA>, <Payor & Office Code>, <Receiver Code>, <GS03>, <Eligibility Receiver> filled in with the ‘Identification Number’ from the following website:  www.cms.gov/cobagreement/downloads/contacts.pdf.

* INTELLECT - Fields are <COBA>, <Payor & Office Code>, <Receiver>, and <Payer Identifier>.

CTX SITUATIONAL TRIGGER 2320 + IK3 SBR 2320:

Added 02-02-2012

Solution: UNIX - If the Secondary insurance is a Federal Program the patient insurance screen for the secondary insurance needs the <Status> field filled in.

Added 02-02-2012

** I10=Implementation “Not Used” Data Element Present, ‘1’= the bad data

Solution: Charge posted with no diagnosis yet <RDX>=1 so either add diagnosis or ste <RDX>=blank

IK3 2330:

CTX*SITUATIONAL TRIGGER*N4*681*2330*4

N4 usually indicates a zip code error.

2330 indicates the ANSI 5010 Loop.

The account number is located in the CTX:CLM01 line. For example:

• Intellect: CTX:CLM01:1.0002837: 1 represents the clinic#, 2837 the pt acct number

• OnStaff 2000: CTX:CLM01:0002837 represents the pt acct number

Solution: Check the zip code for the insurance, making sure that it matches the city and state.

IK3=NM1-2330

Solution: This issue is related to special characters in the Utility/Insurance/Name. 5010 does not allow special characters. Go to Utility/Insurance/Modify and remove all special characters.  

Added 02-02-2012

Solution:

UNIX -  The /Ins/<Address>

‘1234 HAPPY RD ATTN:CLAIMS’  is invalid.

Remove the ‘ATTN:CLAIMS’ and rebill.

NOTE: The following special characters may NOT be used:

‘~’, ‘*’, ‘:’.

IK3 2400:

Added 02-02-2012

PROBLEM: Wrong modifier. Must be 2 characters

SOLUTION: Fix and resubmit

Added 02-02-2012

   -OR-

Problem: Wrong diagnosis pointer:

• 2 diagnoses posted yet 3 indicated in <RDX>

-or-

• 3 diagnoses posted with diagnosis 1 and diagnosis 3 the same and <RDX>=123 so either delete the third and set <RDX>=12 or just change <RDX> to ‘12’.

Solution: Fix and resubmit

CAPARIO Rejections

Added 02-02-2012

[ACKNOWLEDGEMENT/RETURNED AS UNPROCESSABLE CLAIM]

[Element SBR05 is missing. It is required when SBR01 is not ‘P’ and payer]

[is Medicare.]

Solution:

Whenever Medicare is ‘S’econdary , Patient Insurance <Status> is required

ENS Rejections

Added 02-02-2012

Rejection Code:H20658

Rejection Descr: Segment REF exceeded HIPAA max use count.

Segment Cnt: Loop: 2010AA Element: 0 Sub Element:  0

Solution:

* INT - Set /Insurance/<NPI Support>      = X

* UNIX - Set /Insurance/<NPI(Y/N/P/X)>  = X

Added 02-02-2012

The client receives the following on the  ‘ELECTRONIC RESPONSE REPORT’, e.g.,

TRICARE – West Region ELECTRONIC RESPONSE REPORT:

CLAIM STATUS: [ERR CODE:           A3   21   Acknowledgement/Returned as]

CLAIM STATUS: [unprocessable claim-The claim/0000000000]

Solution:

Client to do nothing. ENS will resubmit claim for the client. The client will then wait 2-3 days for

an updated ‘ELECTRONIC RESPONSE REPORT’ without this error.

Added 02-02-2012 

Acknowledgement / Rejected for relational field in error

Submitter not approved for electronic claim submissions on behalf of this entity.

Solution:

This is a problem that occurred at Palmetto and the claim(s) needs to be resubmitted.

GATEWAY Rejections

Added 02-02-2012

***4010 Claims Only***

Validation error – Extra data was encountered. DTP segment could not be validated due to unrecognized d’.

Solution:

This is something GW had a problem with at their end and have worked it out.

Please rebill the claims.