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HCPCS Procedure Code is invalid in Professional Service

Rejection Message Rejection Details Resolution

HCPCS Procedure Code is invalid in Professional
Service

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

Submitter Action:

  1. Check the date of service.
  2. Check an up to date CPT or HCPCS Code Book (or online code resource) to make sure ALL codes submitted on the claim are valid for the date of service listed.

Tip:  Most Kareo PM subscription levels include access to a free code scrubbing tool on the Encounter. Utilizing this feature for all encounters can help prevent code rejections.

NOTE: Kareo Support cannot provide coding assistance. Please contact your biller/coder with any CPT or ICD code questions. 

Once the invalid code has been identified it can be updated or removed from the encounter.

Follow the instructions below to change the  procedure code listed on a claim:

  1. Click Encounters > Track Claim Status.
  2. Look for and double-click on the encounter that needs correcting.
  3. On the Edit Claim window, double-click on the Encounter number. 
  4. Click into the Procedure cell and replace the CPT with a valid code.
  5. Click Save and Rebill.

Then, resubmit all affected claims.

Follow the instructions below if the procedure code needs to be removed from the claim:

  1. Click Encounters > Track Claim Status.
  2. Look for and double-click on the encounter that needs correcting.
  3. Click Action > Void > Apply.

 4. Click Save all the way out.

Then, rebill and resubmit all affected claims.

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