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Common ICD-10 Related Rejection
Posted on 02 October 2015 12:20 PM

Rejection Message: Payer does not Accept ICD-9 Diagnosis Codes for this DOS

This means that you have an ICD Indicator of 9 (ICD-9) chosen, but the Payer does not accept ICD-9 coded claims for the Date of Service. You will need to update the ICD Indicator to 0 (ICD-10) and ensure that you are coding the claim in ICD-10 codes in Box 21 A-L.

If you create your claims via one of the Office Ally applications (Online Entry, Practice Mate, EHR) and did not select an ICD Indicator in the upper right corner of box 21, make sure you are choosing either 9 (ICD-9) or 0 (ICD-10) when filling out your claims.

NOTE: Claims can take up to 24 hours from the time of submission before they are available for correction in Claim Fix.  If you do not see the claims yet, please allow more time for processing.

When creating your claims, be sure to bill on the “new” claim form (02/12 CMS 1500) and in box 21, select “0” in the ICD Indicator field in the upper corner of that box if you’re sending ICD-10 codes.

If you received this error but you create your claims in an outside billing software and upload the file to Office Ally, please contact our Customer Service department via chat, email (, or by phone (360-975-7000 opt 1).  Please have a claim or file ID example ready when contact for quickest assistance.

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Erroneous Regence Dental Rejections
Posted on 22 April 2015 10:44 AM

From 4/9-4/20, claims may have failed for the following reason:

Printing Services Not requested, to enable contact (360)-975-7000 option 1 RC68

There was a routing issue within the Office Ally system that caused claims to reject.  Claims can be resubmitted from claim.  We apologize for any inconvenience. 

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Cigna HealthSpring 63092 (12/13/14-1/21/15 Batches)
Posted on 30 January 2015 11:56 AM

We received information from the Cigna HealthSpring (Payer ID 63092) on 1/19/15 that claims sent between 12/13/14-1/21/15 may have rejected for the following reason:


Some claims were rejected in error.  The payer is identifying all affected claims and will be reprocessing on their end.  No need to resubmit.  Please check claim status at the payer in 5 business days to verify if claim has been reprocessed.

Please Note: Not all claims rejected in error.  If the claim is still not on file, please verify the ID at the payers end.  If they verify it is correct please contact our customer service department either by phone (360-975-7000 opt 1), by email ( or via or Live Chat (link to the left) so a ticket can be opened.  Need to have a copy of the patient's ID card ready to fax in.

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Blue Cross CA BC001 (12/13/14-1/15/15 Batches)
Posted on 22 January 2015 06:05 PM

Blue Cross sent out this notification on Monday, 1/19/15:

Important Information Regarding: Inpatient Behavioral Health claims are rejecting in error for edit 60401.

We identified and resolved a processing issue for inpatient Behavioral Health claims files sent December 13, 2014 through January 15, 2015 that were erroneously rejecting.

You may have been impacted in error for the following edit:

60401: Facility Code (Loop 2300 CLM05) equals 11X or 21X, at least one accommodation revenue code 010X or 021X (Loop 2400 SV201) must be provided.

Please do not resubmit the claims that rejected for edit 60401, Anthem will proactively resubmit the claims for processing. If your Level 2 Report with the 60401 edit includes additional claim rejections, correct the other errors and resubmit those claims for processing.

We apologize for any inconvenience and appreciate your patience in this matter.
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United Healthcare (1/1/14-1/20/14 Batches)
Posted on 20 January 2015 05:24 PM

EDI Claims Rejecting in Error with Reason Code H51000 or H54264

UnitedHealth Group identified a system issue that is causing electronic data interchange (EDI) claims with new HCPCS codes effective on Jan. 1 to reject in error.  Claims with the following HCPCS codes are being rejected most frequently: G6031, G6056, G6058, and J1071. The error and message is:  H51000 The Procedure Code is not a valid CPT or HCPCS Code for this Date of Service.


Additionally, claims are being rejected incorrectly with the message: H54264 Claim Adjustment Reason Code ‘23’ can only be used with Claim Adjustment Group Codes ‘OA’.


A system update at United HealthCare will be implemented on the evening of Jan. 20 to fix these issues. It is recommended that providers hold impacted claims until Jan 21. Claims can be resent after that date.

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