| 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 |
