BlueCard Host Claim Edits

Professional Basics

100

Procedure code not found

BPC

200

Duplicate claim 

DUP

300

Other insurance carrier information needed 

EOB

400

Invalid service type 

ITS

500

NPI's are mismatched 

NPI

Professional Advanced

100

Non-par lab pricing 

NPL

200

Claim is returned from MARS with pricing determinations/instructions

NRR

300

Provider is mismatch and it MUST match 

PBE

400

No provider relationship 

PCR

500

NOC code under review 

U99

Facility Basics

100

Zero allowance found on claim

ALZ

200

Ambulance must be priced per line 

AMB

300

Claim submitted on wrong form, should be CMS-1500

CMS

400

DRG 998/999 triggers routing 

DRG

500

Gamma knife procedure review 

GAM

Facility Advanced

100

Interim billing adjustment needed 

INT

200

Device intensive pricing review 

ISU

300

Provider under review only 

PBR

400

Unknown EX code returned 

PEX

500

PPM timeout reprocess 

PPM

BONUS!

100

Bill types 111, 112 and have a case allowance 

Inpatient Claim 

200

Pricing Method/Rule 20/012/028

Per diem 

300

System used to house claims 

POWER

400

15-digit number that is created when a claim is entered into the system. BlueCard starts with "520"

SCCF number