Claims Submitted with an Accident Diagnosis Must Indicate if the Accident was due to a Work Injury, an Auto Accident or Other Accident

Rejection Details:

This rejection indicates that a Related Causes (Accident) code was not included with the claim and is required by this payer for the service billed. The 2300 Loop, CLM11 is reserved for Related Causes Codes. This was not sent on the claim, and it is required.

Resolution:

Kindly use the following workflow:

  •  Patient > Clinical > Case Review
  • Click on Add > Select “Accident” as the Type
  • Scroll down to Accident Details
  • Select “AA. Auto Accident” as Condition Related to
  • Enter the Accident Date & Accident State and Save the case
  • Go back to the charge screen of the appointment date
  • Click on the double-arrows pointing downwards next to Insurance section
  • Select the Case from the Appointment section and save the charge