Claim Error: Service line is unbalanced due to nonstandard adjustment reason codes (2430_AMT_02 Remaining Patient Liability)

Claim Error: Service line is unbalanced due to nonstandard adjustment reason codes (2430_AMT_02 Remaining Patient Liability)

This happens if you have not used standard adjustment reason codes (codes from EOB, not in-house codes) when billing secondary claims on the 837-5010 claim format. 

Examples of standard codes are: 

• PR 1
• PR 2
• CO 45

Examples of non-standard codes:

• R & C
• Self Pay
• Co-Pay

FIX:

1. Right-click on the claim error and Open Transactions
2. Select the DOS.
3. Select the payment line.
4. Right-click Edit Transaction.
5. Now you can select a standard reason code instead. Be sure not to change any other info. You will need to do this for every payment line that has a non-standard reason code for this DOS. 
6. When you are done, generate claims again. 

NOTE: If you send 837s and use 835 Posting in the system, all the codes will be added automatically for you.