ICD-9

ICD-10

Principal Diagnosis Code

BK

ABK

Admitting Diagnosis Code

BJ

ABJ

Patient Reason for Visit

PR

APR

External Cause of Injury

BN

ABN

Other Diagnosis Code

BF

ABF

Principal Procedure Code

BR

BBR

Other Procedure Code

BQ

BBQ

If 2300.HI01-1 is not equal to "BK" or "ABK", the claim is rejected.

Receive 999R with:
IK403 = 7: "Invalid Code Value"

When there is more than one iteration of 2300.HI with HI01-1 = "BK" or "ABK" the claim is rejected.

Receive 999R with:
IK304 = 5: "Segment Exceeds Maximum Use"

If 2300.HI01-1 is "ABK" then 2300.HI01-2 must be a valid ICD-10 Diagnosis code, otherwise claim is rejected.

Receive 999A and 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 254: "Principal diagnosis code

Only one iteration of 2300.HI with HI01-1 = "BJ" or "ABJ" is allowed, otherwise claim is rejected.

Receive 999R with:
IK304 = 5: "Segment Exceeds Maximum Use"

If 2300.HI01-1 is "ABJ" then 2300.HI01-2 must be a valid ICD-10 Diagnosis code, otherwise claim is rejected.

Receive 999A and 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 232: "Admitting Diagnosis"

Only one iteration of 2300.HI with HI01-1 = "PR" or "APR" is allowed, otherwise claim is rejected.

Receive 999R with:
IK304 = 5: "Segment Exceeds Maximum Use"

If 2300.HI01-1 is "APR" then 2300.HI01-2 must be a valid ICD-10 Patient Reason for Visit code, otherwise claim is rejected.

Note: applies to all occurrences

Receive 999A and 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 673: "Patient reason for visit"

Only one iteration of 2300.HI with HI01-1 = "BN" or "ABN" is allowed, otherwise claim is rejected.

Receive 999R with:
IK304 = 5: "Segment Exceeds Maximum Use"

If 2300.HI01-1 is "ABN" then 2300.HI01-2 must be a valid ICD-10 External Cause of Injury code, otherwise claim is rejected.

Note: applies to all occurrences.

Receive 999A and 277CA with:
CSCC A7:"Acknowledgement /Rejected for Invalid Information…"
CSC 509:"E-Code"""

Only two iterations of 2300.HI with HI01-1 = "BF" or "ABF" are allowed, otherwise claim is rejected.

Receive 999R with:
IK304 = 5: "Segment Exceeds Maximum Use"

If 2300.HI01-1 is "ABF" then 2300.HI01-2 must be a valid ICD-10 Diagnosis code, otherwise claim is rejected.

Receive 999A and 277CA with:
CSCC A7:"Acknowledgement /Rejected for Invalid Information…"
CSC 255: "Diagnosis Code"""

Only one iteration of 2300.HI with HI01-1 = "BR" or "BBR" is allowed, otherwise claim is rejected.

Receive 999R with:
IK304 = 5: "Segment Exceeds Maximum Use"

If 2300.HI01-1 is "BBR" then 2300.HI01-2 must be a valid ICD-10 Procedure code, otherwise claim is rejected.

Receive 999A and 277CA with:
CSCC A7: ""Acknowledgement /Rejected for Invalid Information…"
CSC 465: "Principal Procedure Code for Service(s) Rendered"

Only two iterations of 2300.HI with HI01-1 = "BQ" or"BBQ" are allowed, otherwise claim is rejected.

Receive 999R with:
IK304 = 5: "Segment Exceeds Maximum Use"

If 2300.HI01-1 is "BBQ" then 2300.HI01-2 must be a valid ICD-10 Other Procedure code, otherwise claim is rejected.

Receive 999A and 277CA with:
CSCC A7:"Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 490:"Other Procedure Code for Service(s) Rendered"

If 2300.HI with HI01-1 = "BK", all applicable diagnosis code HI segments must contain only ICD-9 qualifiers, otherwise the claim will reject.

Receive 999A and 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 255: "Diagnosis Code"

If 2300.HI with HI01-1 = "ABK", all applicable diagnosis code HI segments must contain only ICD-10 qualifiers, otherwise the claim will reject.

Receive 999A and 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 255: "Diagnosis Code

If 2300.HI with HI01-1 = "BR", all applicable procedure code HI segments must contain only ICD-9 qualifiers, otherwise the claim will reject.

Receive 999A and 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 454: "Procedure code for services rendered."

If 2300.HI with HI01-1 = "BBR", all applicable procedure code HI segments must contain only ICD-10 qualifiers, otherwise the claim will reject.

Receive 999A and 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 454: "Procedure code for services rendered."

When ISA15 = "P" and HI01-1 is not equal to "BK", the claim rejects.

Receive 999E with:
IK403 = I12: "Implementation Pattern Match Failure"

Receive 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 254: "Principal Diagnosis Code"

When ISA15 = "P" and HI01-1 is not equal to "BF", the claim rejects.

Receive 999E with:
IK403 = I12: "Implementation Pattern Match Failure"

Receive 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 255: "Diagnosis Code"

When ISA15 = "P" and HI01-1 is not equal to "BR", the claim rejects.

Receive 999E with:
IK403 = I12: "Implementation Pattern Match Failure"

Receive 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 454: "Procedure code for services rendered."

When ISA15 = "P" and HI01-1 is not equal to "BQ", the claim rejects.

Receive 999E with:
IK403 = I12: "Implementation Pattern Match Failure"

Receive 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 490: "Other Procedure code for services rendered."

When ISA15 = "P" and HI01-1 is not equal to "BJ", the claim rejects.

Receive 999E with:
IK403 = I12: "Implementation Pattern Match Failure"

Receive 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 232: "Admitting Diagnosis Code"

When ISA15 = "P" and HI01-1 is not equal to "PR", the claim rejects.

Receive 999E with:
IK403 = I12: "Implementation Pattern Match Failure"

Receive 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 673: "Patient Reason for Visit"

When ISA15 = "P" and HI01-1 is not equal to "BN", the claim rejects.

Receive 999E with:
IK403 = I12: "Implementation Pattern Match Failure"

Receive 277CA with:
CSCC A7: "Acknowledgement /Rejected for Invalid Information…"
CSC 732: "Information submitted inconsistent with billing guidelines."
CSC 509: "E-Code"