Rejection Codes

Code Description
101 Missing/Invalid Agency Number
102 Date of Service Is Before Agency's Certificate Date
103 Missing/Invalid Client ID Number
104 Missing/Invalid Transaction Type
105 Missing/Invalid Date of Service
106 Missing Client Name
107 Missing/Invalid Birth Date
108 Missing/Invalid Recipient Number
109 Missing/Invalid Staff ID Number
110 Service Location Conflicts with Billing Option Code and Service Date
111 Missing/Invalid Geographic Code
112 Missing/Invalid Location Code
113 Missing/Invalid Option Code
114 Service Option Code is Invalid for the Service Date Reported
115 Date of Service is out of Fiscal Year Coverage
116 Missing/Invalid Program Code
117 Missing/Invalid Diagnosis Code
118 Missing/Invalid Service Activity Code and/or Billing Option Code
119 Missing/Invalid Units of Service
120 Missing/Invalid Hours of Service
121 Missing/Invalid Minutes of Service
122 Hours and Minutes of Service Both Cannot Equal Zeroes
123 Invalid TPL Code
124 Missing/Invalid TPL Status
125 Missing/Invalid TPL Payment Amount
126 Missing/Invalid Adjudication Date
127 Missing/Invalid Charge Amount
128 Missing/Invalid Submit Date
129 Missing/Invalid Original Document Control Number
130 Missing/Invalid Adjustment Purpose
131 Missing/Invalid Original DPA Voucher Number
132 Missing/Invalid Adjustment Type
133 Missing/Invalid Adjustment Service Code
134 Missing/Invalid Charge Amount
135 Missing/Invalid DPA Site Number
137 Adjustment Purpose and Amount Conflict
138 Invalid Region Number
139 Missing Location Description
140 Duplicate Service
141 No Matching Claim Transaction Found On File
142 Adjustment Too Old To Process
143 Units Do Not Meet Minimum Units Required
144 TPL Data in Occurrence 2 Not Allowed on Adjustments
145 No Prior Approved Claim Found for this Adjustment Transaction
146 TPL Data Not Allowed on this Adjustment
147 Missing/Invalid Total TPL Amount
148 Missing Units of Service or Adjustment Activity Code for Adjustment Type
149 Program and Billing Option Code Conflict
150 Program and Service Activity Code Conflict
151 Service Date Before Program Code or Activity Code Effective Date
152 Adjustment Medicaid Time is Greater than Service Time Reported
153 Adjustment Type Conflicts with Another Adjustment
154 Duplicate Adjustment
155 Service too old to Process
156 Adjustment of a Voided Service Not Allowed
157 Invalid TPL Status for an Adjustment
158 Service Rejected - DHS Software needs to be updated
190 MH Services After 06/30/08 Must be Reported to the Collaborative
197 Service Time Exceeds 24 Hours for Date of Service
198 Rejected per the Office of Mental Health Request
199 Rejected per Agency Request
201 Invlaid Unit Code
202 Invalid Unit/Program Code Combination
203 Invalid Activity Code
204 Client not Eligible for Medicaid Reimbursement Until Spend-down is Met
205 Claim Amount is Greater than Fiscal Year Contract Amount
206 Adjustment Amount is Greater than Fiscal Year Contract Amount
207 Invalid Region/Agency Combination
208 No Contract on File for the Service Date
209 No Contract on File for the Fiscal Year
210 Invlaid Adjustment Charge Amount
211 No Matching Claim Transaction Found on  File
212 TPL Amount is Greater than Charge Amount
213 No Matching 325 Fund Dollars Available
214 No Matching Grant Dollars for Unit/Program
215 Case Opening Not Found for Individual
216 Case Opening Not Found for Service Date
217 Case Opening Must Be Marked as HCB Waiver
225 NPI Not on File for Agency FEIN and DHFS Site Code Combination
301 Invlaid or Missing Agency FEIN
302 Invlaid or Missing Agency Satellite Code
303 Invlaid or Missing Service Recipient Type
304 Invalid or Missing Unregistered Client ID
305 Client ID Must be Spaces for Community/Own Agency Service Recipient Types
306 Invlaid or Missing Record Type
307 Invlaid or Missing Site ID
308 Invlaid or Missing Service Activity Code
309 Invlaid or Missing Number of Staff in Group
310 Invlaid or Missing Number of Clients in Group
311 Invalid Combination of Number of Staff and Clients in Group
312 Invlaid or Missing Contractor FEIN
313 Invlaid or Missing Service Reporting Hours
314 Invlaid or Missing Service Reporting Minutes
315 Both Hours and Minutes Cannot be Zero for Service Reporting
316 Invalid Daily Attendance Entry for Monthly Service Reporting
317 Must Report at Least One Day of Service for Monthly Service Reporting
318 Invalid DHS Case ID Number
319 Invalid Agency Group ID Number
320 Invalid Adjustment Type and Adjustment Purpose Combination
321 Cannnot Bill Medicaid on Monthly Service Reporting
322 Invalid Daily Attendance Reported for Monthly Service Reporting
323 Invalid Daily Time Reported for Monthly Service Reporting
324 Invalid or Missing Daily Entry for Monthly Service Reporting
327 Cannot Bill Medicaid for Unregistered Clients
328 Missing Service Reporting Hours/Minutes for Adjustment Type
329 Invalid or Missing Service Start Time
330 Invalid Total Dollars Spent on Client
401 Agnecy FEIN Not on File
402 Site/Unit/Program Combination Not on File
403 Client Registration Not on File
404 No Agency Plan on File for Date of Service
405 Client Registration Period not found for Date of Service
408 Program Identified as MH
409 Medicaid Time is Greater than Service Time Reported
410 FEIN and/or Client Do Not Match Those Found on Service for Original DCN
411 SST Authorization Period Not Found for Date of Service

Warning Codes

Code Description
801 Charge Amount was Re-Computed and Changed
802 Net Charge Amount was Re-Computed and Changed
803 Adjustment Charge Amount was Changed
804 Multiple Claim Reduced to Maximum Time/Amount Allowed
902 Untis of Service was Re-Computed and Changed
903 TPL Status Changed to Spaces
904 TPL Amount Changed to Zeros
905 TPL Adjudication Date Changed to Spaces
906 Total TPL Amount was Re-Computed and Changed
907 Net Charge Amount was Re-Computed and Changed
908 Adjustment Type Changed to Spaces
909 Adjustment Service Code Changed to Spaces
910 Adjustment Charge Amount Changed to Zeros
911 Original DPA Voucher Number Changed to Spaces
912 Original DPA Document Control Sequence Number Changed Due to Multiple Claims
913 Charge Amount was Changed to Zeros
914 Net Charge Amount was Changed to Zeros
915 Units of Service Changed to Zeros
916 Hours of Service Changed to Zeros
917 Minutes of Service Changed to Zeros
918 Adjustment Purpose changed to spaces
919 Adjustment TPL amount was lowered
920 Units of Service Changed to Maximum Allowed
921 Program Code was changed to spaces
922 Service Code was changed to Mental Health Assessment
923 Missing Service Location Code changed to on-site for MH Medicaid Bill
924 Service Option Code was changed
925 Invalid Daily Entry for Service Month was changed to spaces
926 Activity Code was changed to spaces
927 Satellite Code was changed to zero