Claim Rejections

Blue Shield CA BS001

Rejection: Normal-0x3939612-Value of sub-element SV202-02 is incorrect. Expected value is from external code list - HCPCS Code (130) when SV202-01='HC'. Segment SV2 is defined in the guideline at position 3750.This error was detected at Segment Count 34Co

What happened: Either the procedure code (box 44) or the SVC qualifier is incorrect.

Resolution: Verify the code is billable at the payer. Also, verify if the code being sent is a HIPPS code or a HCPCS code. If it is a HIPPS code, send the qualifier of 'ZZ' or 'HP' in the 'SVC Qual' box on the claim form right before box 44. If it is a HCPCS code, send the qualifier of 'HC' in the 'SVC Qual' box on the claim form right before box 44.