TOP 10 HIPAA 5010 denial

The 5010 electronic media claims (EMC) system reviews every file for a number of edits to ensure that claim data is valid. Below are the top 10 Common Edit Module (CEM) edits for 837 Part B Professional claims, in order of volume.

Edit Number	Business Edit Message
X222.121.2010BA.NM109.020	This Claim is rejected for Invalid Information for a Subscriber’s contract/member number (A7:164:IL)
X222.087.2010AA.NM109.050	This Claim is rejected for relational field due to Billing Provider’s submitter not approved for electronic claim submissions on behalf of this Billing Provider (A8:496:85)
X222.157.2300.CLM05-3.020	This Claim is rejected for Invalid Information within the Claim Frequency Code (A7:535)
X222.351.2400.SV101-7.020	This Claim is rejected for relational field Information within the Detailed description of service (A8:306)
X222.094.2010AA.REF02.050	This Claim is rejected for relational field Billing Provider’s NPI (National Provider ID) and Tax ID (A8:562:85 – A8:128:85)
This Claim is rejected for Invalid Information in the Billing Provider's NPI (National Provider ID) (A7:562:85)

X222.262.2310B.NM109.030
X222.376.2400.CRC.015	This Claim is rejected for relational field Information within the Hospice Employee Indicator for Missing or invalid information (A8:21:747)
X222.176.2300.DTP.010	This Claim is rejected for Invalid Information for the Future date within the Facility admission date (A7:189)