Background
On an insurance claim, there are the diagnosis codes (these are the diagnosis codes for the patient) in BOX 21 and there are the diagnosis pointers (where you point to diagnosis codes (from Box 21). The diagnosis pointers (known as treatment diagnosis in Therabill) are entered on the service lines (Box 24 on the CMS-1500) for each service in Box 24E.
This Rejection
One or more of your treatment diagnosis (diagnosis pointers) which are entered on the add / edit session form are pointing to an invalid diagnosis code for the patient (entered on the add / edit client form). An example of this would be having 3 diagnosis codes entered in Box 21, but pointing to 4 diagnosis codes in Box 24E.
How does this happen?
This often occurs when you set up the patient with diagnosis codes (i.e. 4 diagnosis codes). You then create a session and point to all 4 diagnosis codes (in the treatment diagnosis on the add session form). Subsequently, you delete one of the diagnosis codes associated with the patient. Changing the diagnosis codes with the patient does NOT change sessions that you have entered.
How to Fix
This can usually be fixed simply by opening up the edit session form for the sessions on this claim and saving it. Opening up the edit session form will load the new diagnosis codes and adjust the treatment diagnosis. Saving it will then save the new treatment diagnosis with the session.
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