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:
- Right-click on the claim error and Open Transactions
- Select the DOS.
- Select the payment line.
- Right-click Edit Transaction.
- 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.
- 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.