Part A Electronic Claim Tips


Palmetto GBA has seen an increase in Part A and HHH claims being rejected for the following front-end edit issues:

  • Alpha Numeric (AN) data elements: Per TR3, B.1.1.3.1.4 string, AN data elements may not have trailing spaces unless it is to meet the minimum data element requirement.
  • XV qualifier: The XV qualifier is not allowed in Payor Loops 2010AC, 2010BB, & 2330B.
  • Phone Numbers & Extensions: In the PER Segments, the EX (extension) must follow the TE (phone number).
        For example, PER*IC*JOHN SMITH*TE*8035551234*EX*123~
  • Inpatient & Outpatient Services: CL102 must be present for all Inpatient and Outpatient service claims.

Please carefully review your Part A and HHH claims prior to submission to ensure your claims are not rejected by these front-end edit issues, thus delaying the processing of your claims.





Last Updated: 04/02/2021