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Acknowledgement/Rejected for Invalid Information Procedure Code-XXXXX Modifier(s)-XX SVC Line Response - Procedure Code Modifier(s) for Service(s) Rendered Procedure Code-XXXXX Modifier(s)-XX SVC

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Rejection Message

Acknowledgement/Rejected for Invalid Information Procedure Code-XXXXX Modifier(s)-XX SVC Line Response - Procedure Code Modifier(s) for Service(s) Rendered Procedure Code-XXXXX Modifier(s)-XX SVC

Rejection Details

This rejection indicates (per the payer) one of the procedure (CPT/HCPCS) modifiers submitted on the claim was invalid for the date of service being billed.

Resolution

The submitter should contact the payer to review the billing rules. Specifically, find out from the payer if the procedure code/modifier combinations listed on the claims are allowed.

Follow the instructions below to edit a procedure code or modifier:

  1. Click Encounters > Track Claim Status. The Find Claim window opens.
  2. Look for and double-click on the encounter that needs correcting. The Edit Claim window opens.
  3. Double-click on the Encounter number. The Edit Encounter window opens.
  4. Click into the Procedure cell and replace the procedure code, as needed. 
  5. Click into the MOD cell and replace the modifier, as needed.
    • To delete a modifier, select the modifier and click Delete on your keyboard.
  6. Click Save & Rebill. 

Then, resubmit all affected claims.

 Encounter_ProcedureMod.png

Follow the instructions below if the procedure code needs to be removed from the claim:

  1. Click Encounters > Track Claim Status. The Find Claim window opens.
  2. Look for and double-click on the encounter that needs correcting. The Edit Claim window opens.
  3. Click Action > Void > Apply.
  4. Click Save all the way out (multiple saves may be required).

Then, rebill and resubmit all affected claims. 

 Claim_Void.png

Tip: Most subscription levels include access to a free code scrubbing tool on the Encounter. Utilizing this feature for all encounters can help prevent code rejections.

Note: Kareo Support cannot provide coding assistance. Please contact your biller/coder with any CPT or ICD code questions.