Warning Message

Explanation

Warning: Laterality modifier inconsistent. AI comment: {Comment}

This warning indicates a mismatch between the laterality modifier and the clinical documentation.

Warning: Unusual name

This warning indicates that there may be an error in patient’s name.

Warning: Missing auth.

This warning means there is a missing authorization number on the claim

Warning: Unvalidated primary insurer. Possible IPA/Medical Group billing. Please check Insurance ID to submit the claim to the right payer.

This warning indicates that the primary insurer could not be fully validated and the claim may need to be billed through an IPA or Medical Group. Please review the Insurance ID and ensure the claim is submitted to the correct payer.

Warning: Complex surgery codes.

This warning indicates that the claim includes complex codes and may require additional review before submission.

Warning: This payer is a Paper payer. Please print and mail/fax to the payer.

This warning indicates that the payer does not accept electronic submissions and requires paper claims. Please print and mail or fax the claim to the payer.

Warning: Expensive drug.

This warning indicates that the claim includes expensive drugs and may require additional review before submission.

Warning: Post-Op case without prior surgery bill. Please ensure surgery will be billed.

This warning indicates that the claim is marked as a post-operative visit, but no corresponding prior surgery has been billed for the patient.

Warning: Check order of ICD codes.

This warning indicates that the ICD codes may be in an incorrect order. Please review and adjust the ICD code sequence if needed.

Warning: Medicare secondary missing.

This warning indicates that Medicare is expected as a secondary payer, but no Medicare secondary insurance is listed on the claim.

Warning: Unvalidated secondary insurer. Possible IPA/Medical Group billing.

This warning indicates that the secondary insurer could not be fully validated and the claim may need to be billed through an IPA or Medical Group. Please review the Insurance ID and ensure the claim is submitted to the correct payer.

Warning: Please verify the correct Units billed for the CPT code(s) with bilateral modifier -50.

This warning indicates that one or more CPT codes include the bilateral modifier (-50) and that the units billed may require review.

Warning: 2 or more J codes found on this claim. Please review chart note and correct if needed.

This warning indicates that multiple J-codes have been identified on the same claim. In some cases, multiple J-codes may be valid, but they often require careful review to ensure they are billed correctly.

Warning: Telemedicine modifiers present, but facility code is not telemedicine-eligible

This warning indicates that telemedicine modifiers are present on the claim, but the selected facility code is not eligible for telemedicine services. Please review the facility code and modifiers and update them as needed.

Warning: One or more CPT code(s) has $0 charge amount: {CPT Code 1}, {CPT Code 2}, ….

This warning indicates that one or more CPT codes have a $0 charge amount. Please review and update the charge amounts as needed.

Warning: Facility Name in box 32 is not found.

This warning indicates that the Facility Name entered in Box 32 could not be found or does not match a recognized facility. Please review and update the facility information as needed.

Warning: Please review chart note to code the right Q code.

This warning indicates that the Q code may be incorrect. Please review the chart note and update the Q code as needed.

Warning: this claim has duplicated Q codes.

This warning indicates that the claim contains duplicate Q codes. Please review and remove any duplicate codes if needed.

Warning: CPT code unit exceeds the Medically Unlikely Edit (MUE) limit for {99213 - MUE: 1}, {20610 - MUE: 2}

This warning indicates that the units billed for one or more CPT codes exceed the Medically Unlikely Edit (MUE) limit. Please review and adjust the units if needed.

Warning: Fee not found: {CPT Code}. Please add medicare fee and schedule based on practice locality

This warning indicates that the system could not find a Medicare fee amount for the CPT code based on the practice’s assigned locality.

Error Message

Explanation

Error: Admit Date after DOS

This error indicates that the Hospital Admit Date is later than the Date of Service (DOS), which is not valid in claim submission logic.

Error: Missing admit date from practice. System defaulted to DOS. Please verify and change it to the correct admit date.

This error indicates that the Admit Date was not provided by the EHR. As a result, the system automatically defaulted the Admit Date to the Date of Service (DOS).

Error: Facility code in box 24b and Facility in box 32 are inconsistent

This error indicates a mismatch between the Facility Code entered in Box 24b and the Facility information listed in Box 32 on the claim form.

Error: Prior surgery within 90 days. Please review related surgeries and add necessary modifiers.

This error indicates that the patient had a prior surgery within the 90-day global period, and the current procedure may be affected by global surgery billing rules.

Error: Missing mandatory drug info such as NDC and dosage.

This error indicates that required drug information is missing, such as the NDC and dosage. Please add the missing details before submitting the claim.

Error: Missing valid modifier. NCCI edit: primary_code: 20610, secondary_code: 64450. Please review the case and update coding/modifiers.

This error indicates that the claim failed an NCCI edit. The primary CPT code (20610) and secondary CPT code (64450) require a valid modifier to indicate that the services were performed separately or meet NCCI requirements.

Error: Secondary Insurance Unknown: {Secondary Insurance EHR Name}. Need mapping between EHR name and Clearinghouse Payer ID.

This error indicates that the system cannot identify the secondary insurance payer because the insurance name from the EHR is not mapped to a corresponding clearinghouse payer ID.

Error: Missing Insured info. Primary Insurance Relation to Insured is Child.

This error indicates that required insured information is missing. Because the Primary Insurance Relation to Insured is set to Child, the system expects insured details that are not currently provided.

Error: Missing insured info. Primary Insurance Relation to Insured is Spouse.

This error indicates that required insured information is missing. Because the Primary Insurance Relation to Insured is set to Spouse, the system expects subscriber details that are not currently provided.

Error: Missing patient address info.

This error indicates that required patient address information is missing from the claim.

Error: Missing primary insurance. Add secondary insurance too if applicable.

This error indicates that the claim is missing a primary insurance record. A claim cannot be processed without a primary payer on file.

Error: Primary insurance unknown: {Primary Insurance EHR Name}. Need mapping between EHR name and Clearinghouse Payer ID.

This error indicates that the system cannot identify the primary insurance payer because the insurance name from the EHR is not mapped to a corresponding clearinghouse payer ID.

Error: Some CPT code(s) in this claim does not have AS modifier.

This error indicates that one or more CPT codes on the claim require the AS modifier but the modifier is missing.

Error: Primary surgeon’s claim is missing. Please investigate and bill the primary surgeon’s claim before submitting this claim.

This error indicates that the primary surgeon’s claim has not been billed or is missing. The current Assistant Surgeon (AS) claim cannot be submitted without the corresponding primary surgeon’s claim.

Error: Some CPT code(s) on this surgical assist claim cannot be found on the primary surgeon's claim.

This error indicates that one or more CPT codes on the Assistant Surgeon (AS) claim do not match any CPT codes on the corresponding primary surgeon’s claim.

Error: VA Reference Number is missing. Please enter the VA Reference Number in Box 23 field.

This error indicates that the VA Reference Number is missing from the claim. This information is required for VA claims to be processed.

Error: Telemedicine modifiers present, but the facility code is not telemedicine-eligible.

This error indicates that telemedicine modifiers are present on the claim, but the facility code selected is not eligible for telemedicine services.

Error: LCD: {SelectCoder Comments}

This error indicates that the claim may not be compliant with LCD (Local Coverage Determination) guidelines

Error: Missing service location in DaisyBill for {facility} with Facility Code {pos_code}. Please escalate to your manager.

This error indicates that the service location for the Facility with that Facility Code is missing in DaisyBill.

Error: CPT code unit should not be 0.

This error indicates that one or more CPT codes on the claim have a unit value of 0, which is not valid for billing.

Error: CPT codes missing ICD-10 codes: {CPT code 1}, {CPT code 2}…

This error indicates that one or more CPT codes are missing associated ICD-10 diagnosis codes. Please add the required ICD-10 codes before submitting the claim.

Error: Facility Name in box 32 is not found.

This error indicates that the Facility Name entered in Box 32 cannot be found.

Error: This claim does not have any CPT code.

This error indicates that the claim does not include any CPT codes, which are required to describe the services provided.

Error: Prior surgery within 10 days. Please review related surgeries and add necessary modifiers.

This error indicates that the patient had a prior surgery within the last 10 days, and the current procedure may be affected by global surgery or post-operative billing rules.

Error: Provider on the claim is not in the system.

This error indicates that the provider listed on the claim cannot be found in the system or is not configured correctly.