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HCPCS Procedure Code is invalid in Professional Service

Updated: 11/04/2021
Views: 24029

Rejection Message

HCPCS Procedure Code is invalid in Professional Service

Rejection Details

This rejection indicates one of the procedure (CPT/HCPCS) codes billed on the claim is not valid for the date(s) of service listed.

Resolution

Refer to an up-to-date CPT/HCPCS code book or online resource and verify all codes submitted on the claim are valid for the date(s) of service. Then, update or remove (void) the service line with the invalid code as necessary.
Note: Kareo Support cannot provide coding assistance. Contact the biller/coder for the practice with any CPT or ICD code questions.

Once the invalid procedure code has been identified, update or remove (void) it:

  • To update the invalid procedure code, follow the steps below:
    1. Click Encounters > Track Claim Status. The Find Claim window opens.
    2. Look for and double click the appropriate claim to open. The Edit Claim window opens.
    3. Double click on the Encounter ID number.  The Edit Encounter window opens.
    4. Under the Procedures section, click on the invalid procedure code listed and update it to a valid code.
    5. Click Save & Rebill. Then, resubmit all affected claims when ready.

EditEncounter_Procedures_ProcedureCode.png

  • To remove (void) the service line with the invalid procedure code, follow the steps below:
    1. Click Encounters > Track Claim Status. The Find Claim window opens.
    2. Look for and double click the appropriate claim to open. The Edit Claim window opens.
    3. Click Action > Void. Additional options expand.
    4. Enter any Notes if necessary then click Apply. The service line is voided.
    5. Close the Edit Claim window then rebill and resubmit all affected claims when ready.

EditClaim_Action_Void.png

 

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