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Claims Submitted with an Accident Diagnosis Must Indicate if the Accident was due to a Work Injury, an Auto Accident or Other Accident

Rejection Message Rejection Details Resolution

Claims Submitted with an Accident Diagnosis Must Indicate if the Accident was due to a Work Injury, an Auto Accident or Other Accident

This rejection indicates that the payer requires an accident date (Qualifier 439) and related cause for at least one of the diagnosis codes included on the claim.

Submitter Action:

Check the diagnosis codes on the claim: If there is a code of 800.00 – 999.99, V01.5, or 535.11 an injury or accident date are required by this payer.
 
Note: Certain payers are actually looking for an Accident Date even if the rejection message says “First Symptom Date.”
 
Follow the instructions below to add an accident date:
  1. Click Encounters > Track Claim Status.
  2. Look for and double-click on the encounter that needs correcting.
  3. Double-click on the Case.
  4. Click on the Condition tab.
  5. Check the appropriate condition box in the “Condition related to” section.
    1. Valid Related Cause codes for Qualifier 439:
      • Auto Accident? = AA
      • Other? = OA
  6. To add the accident date:
    1. In the Date Type drop-down menu, select the “Accident Date.
    2. In the Start Date field, enter or select the date in the drop-down menu.
    3. In the End Date field, enter or select the date in the drop-down menu (if applicable).
    4. Click on the Add button to populate the date to the field below.
  1. Click Save all the way out (multiple saves may be required). 

Then, rebill and resubmit all affected claims.