Common Rejections - Missing Procedure Code Description

Missing Procedure Code Description (Payer or Clearinghouse)

Rejection Message:

PROCEDURE CODE DESCRIPTION IS MISSING OR INVALID

This rejection occurs when the payer requires additional procedure code description detail; this detail is required when sending a non-specific Procedure Code, commonly referred to as NOC code (Not Otherwise Classified).

Note: This rejection can also be prompted from the clearinghouse if the payer has an edit in place to validate the procedure code description before it gets sent to the payer.

To add the procedure code description to an eClaim, go to the Fee Schedule node in the References ability and select the procedure for which this is required. Check the box labeled "Require Description on eClaims" and save the procedure record in the fee schedule. Newly created charges, created from this Fee Schedule will pull the short description into the eClaim. Rebuilding an existing claim with this procedure code should pull the short description into the claim.

Note: Certain characters may cause issues with EDI validation systems. In short descriptions, use alpha and numerical characters only. For example, characters such as &, /, #, and so on should not be used if the description is set to pull into claims.