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A Composite Data Element Marked As Excluded Is Present

Error Message

A composite data element marked as excluded is present. Composite HI04 (Health Care Code Information) is present. This Composite is marked as 'Excluded' and therefore must not be present in the data. Segment HI is defined in the guideline at position 2310.

Description

This error is found in the Electronic Module on a batch report when a service line is billed with too many diagnosis codes. Per HIPAA, some facility types or places of service cannot be billed for more than 3 diagnosis codes per claim.

Resolution

  1. Go to Electronic Module.
  2. Click the Invoice number link.
    • The Invoice window will open.
  3. Double-Click on the service line rejecting.
  4. Click the Diagnosis tab.
  5. Hold down your Ctrl (Command on Mac) key and click to de-select the diagnosis code(s) that aren't needed, leaving 3 or less diagnosis codes selected.
  6. Click Save
  7. Resend the service line.

Note: In some cases, multiple service lines for the same client may be combined on to 1 claim, which may result in a combination of 3 or more unique diagnosis codes on 1 claim. This will cause the rejection because the claim now contains more than 3 unique diagnosis codes. When this happens, be sure that all service lines on the claim have a combined total of 3 unique dx codes or less or resend each service line on it's own, one at a time so they don't combine on to 1 claim.

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