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7.4 Error Report Rejection Conditions – Error Codes

Technical Specifications Interface to Health Care Systems Rejection Conditions 7 - 21 Error Report Rejection Conditions Error Codes General The following Error Rejection Conditions / Error Codes will be reported on the Claims Error Report . Error Reason(s) For Rejection AC4 A valid Referring/Requisitioning Health Care Provider number must be present for this service code The fee schedule code is C813, C815 and the referral number is not in the Midwife range (700000-722899) Referring number is 722900-744292 (Nurse Practitioner) and the billing provider is not a lab (5000 series) and the FSCs are not on the following table: L005 L018 L030 L031 L0

Technical Specifications Interface to Health Care Systems Rejection Conditions 7 - 23 7.4 Error Report Rejection Conditions – Error Codes (continued) General ...

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