Rejection Codes

Code Description
2A Bill Date After Current Date
30 Invalid Program Code
31 Program Code Not Valid for Service Date
32 Program Cannot Have Bed-Hold
33 Invalid Program Predetermined Bill Type
34 Invalid Service Code
35 Invalid Billing Unit for Service Date
36 Invalid Units Value - Check Amounts and Resubmit
37 Invalid Daily Attendance Value
38 Invalid Rate Value
39 Invalid Charge Amount
40 Invalid DMHDD ID Number
41 Invalid Bill Processing Flag
42 Invalid Previous Bill Processing Flag
43 Lapse Period Expired:  Adding/Changing Bills Not Allowed
44 Invalid From Date
45 Invalid Thru Date
46 Program Exceeds Daily Unit Cap
47 Program Exceeds Lifetime Unit Cap
48 Invalid Individual Program Area
49 Must Inter Daily Attendance Values
50 Bill is Before or After ROCS Provider Start/Termination Date
51 Provider Rejected with Invalid FEIN
52 Individual's Problem Area Must Be DD  or DL
53 Invalid Medicaid ID Number
54 Individual Not Eligible for Service
55 No ROCS Case Opening Found for Individual
56 All Fee for Service Program are Terminated for SSN
57 Invalid Combination of Processing Flags
58 Improper Use of Bill Processing Flags
59 Service Date is After Bogard Specialized Services Termination Date
60 Individual Has Refused Specialized Services
61 Name Mismatch with DPA Medicaid
62 Invalid Provider Birth Date
63 Provider Waiver Enrollment is Inactive
64 Invalid Service Mode
65 Service Date(s) Overlap with Another Bill
66 Either a 31A or 31U Bill Paid Already
67 Provider Not Enrolled as Waiver Provider for the Service
68 Client Type and Program Type D Not Match
69 No Prior Approval or Exceeds Approval Amount
6A Personis Bogard in NF, Program Not Authorized
6B Person is CILA, Program Not Authorized
6C Person is Developmental Training Only, Program Not Authorized
6D Person is FAP Stipend, Program Not Authorized
6E Person is DD Home-Based, Program Not Authorized
6F Person is Authorized in Conflicting DD Program
6G Person is Authorized in Conflicting MH Program
6H Person is in State-Operated Facility, Program Not Authorized
6J Client Type Missing
6K Person is MH Home-Based, Program Not Authorized
6L Person is Child Residential Waiver, Program Not Authorized
6M Person is Child Support Waiver, Program Not Authorized
6P Person is Aging Community Waiver
6Q Person is DRS Waiver Program
6R Person is in DSCC Children Waiver
6S Person is in Supportive Living Waiver
70 Program Exceeds Monthly Maximum
71 Bill Exceeds Monthly Combined Maximum
72 Appropriate Professional Credentials Not on File
73 Program Exceeds Fiscal Year Maximum
74 Program Exceeds Combined Fiscal Year or Bed-Hold Maximum
75 No Fee for Service Programs Ever Authorized for SSN
76 Bill Rate Does Not Exist
77 Bill Already Entered by Another Provider
78 Invalid Respite Rate Level
79 Rates Conflicting in System
7A Individual SSN Not Authorized for this Program
7B Bill Includes Dates Before or After Authorized Dates
7C Program Authorized at a Different Provider
80 Cannot Find County Code for Rate
81 Invalid Previous Effective Date
82 Invalid Client Name
83 Invlaid CILA Indicator
84 Invalid CILA Type
85 Invalid Combination of CILA Indicator and CILA Type
86 ROCS Case Opening Lacks Income Information for Service Date
87 Date Must be FY2003 or Later for ROCS Billing
88 Individual Not Medicaid Eligible or Incorrect/No DPA RIN
89 53B Bill Can Only Be Triggered by 60D Bill
8A Income Date Change Transaction, From-Date Not on File
8B Income Date Change Transaction, To-Date Already Exists
90 Client Open in Program Not Compatible with Respite
91 Program Cannot Have Alternate Payee
92 Invalid PC Entry Date
93 Invalid PC Submit Date
94 Provider Expenditure Exceeds Its FY Allocation
95 Individual Not Enrolled in Medicaid
96 DPA RIN Lacking or Incorrect in ROCS
97 Individual Does Not Need Active Treatment
98 Active Treatment Blank or Service Date Before Active Treatment Effective Date
99 No Current Waiver Redetermination
9A Invalid MRO Diagnosis Code
9B NPI Not on File for Service Provider