Claim Rejection: "The Description Is Required When Submitting the Non-Specific Procedure Code"

Claim Rejection: "The Description Is Required When Submitting the Non-Specific Procedure Code"

Claim Rejection: "The Description Is Required When Submitting the Non-Specific Procedure Code"

Error Message

If a claim fails with an error similar to the following:

THE DESCRIPTION IS REQUIRED WHEN SUBMITTING THE NON-SPECIFIC PROCEDURE CODE 'S5150'.
Service Line Data: SVCHC36*****4.00~

the payer or clearinghouse is indicating that the procedure code being billed requires an accompanying code description.

Why This Happens

Some HCPCS procedure codes are considered non-specific procedure codes and require a description to be transmitted along with the code on the claim.

When the code description field is blank in Aaniie, the claim may be rejected with this error.

How to Fix It

  1. Open the client's profile.

  2. Navigate to the client's Billing Code Configuration under ACCOUNTING.

  3. Locate the billing code referenced in the rejection message (for example, S5150).

  4. Edit the billing code configuration entry.

  5. Find the field labeled:

    Code Description (Optional, Not for Nonspecific Procedure Codes)

  6. Enter the appropriate description for the billing code.

  7. Save the changes.

  8. Recreate or resubmit the affected claims as needed.

Finding the Correct Description

The billing code description can typically be obtained from:

HCPCSData.com/codes

To locate the description:

  1. Browse to the section corresponding to the first letter of the code.

  2. Locate the billing code listed in the rejection.

  3. Copy the official description associated with that code.

  4. Enter that description into the billing code configuration.

Example

For code S5150, the description is:

Unskilled respite care, not hospice, per 15 minutes

This description should be entered into the Code Description field so it can be transmitted with the claim.

Summary

When you see an error indicating that a description is required for a non-specific procedure code, check the client's Billing Code Configuration and verify that the Code Description field has been populated with the official HCPCS description for the billing code being billed. Once added, the description will be transmitted with the claim and may resolve the rejection.

Resubmitting Claims After Updating the Billing Code Description

After updating the Billing Code Configuration, any claims that were already submitted will still contain the old information and must be recreated before they can be resubmitted.

To resubmit the claim:

  1. Navigate to the Claims screen.
  2. Locate any claims for the affected client that are in Awaiting Response or In Process status.
  3. Mark those claims as Failed.
    • This tells the system that a replacement claim can be generated.
  4. Navigate to Payer Invoicing.
  5. Regenerate the invoice for the affected client.
  6. Click Create Claim.
  7. Submit the newly generated claim.

The newly created claim will include the updated billing code description and should be sent to the payer with the corrected information.

Important

Simply updating the Billing Code Configuration does not update claims that have already been generated. Existing claims must be failed and recreated so the corrected billing code description is included in the outbound claim.

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