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Ohio Department of Job and Family Services Most Often Encountered Reject Errors

Effective 03/05/2007

ODJFS Error Code Error Description HIPAA 835 Reason Code HIPAA 835 Remark Code
101 Exact duplicate claim. 18
102 Duplicate claim but amount is different. B13
103 Line item errors, however claim denied for another error. 107
120 Claim filing limit exceeded (365 day limit). 29
123 Future date of service was submitted. 16 MA130
127 Date of service greater than date claim was submitted to ODJFS. 110 M52
130 The recipient number entered on the claim may have an incorrect digit, missing digits or contain zeroes. 140 MA61
133 The total claim charge billed does not equal the sum of the individual line item charges billed on the claim. 125 M54
160 A 2,3,4 or 6 was entered as the Other Carrier Reason and there was no Other Carrier Amount. 16 MA92
202 The last two digits of the twelve digit billing number is missing on the invoice. Check medical card for accurate eligibility information. 140 MA61
218 According to JFS eligibility file, the recipient number entered on the claim is covered by another insurance source for the date of service billed and no 3rd party amount was entered on the claim. Bill other insurer prior to billing ODJFS. If the service is not eligible for the 3rd party, use the letter code “S”. 22 MA92
219 Other Carrier Reason (3rd Party) = “R” and claim received prior to 91 day filing limit. 22
225 For a UB-82 last date or non UB-82 first date of service on the claim greater than the Mental Health filing limit. [Note: In MACSIS terms, if the claim service date is greater than 365 days old.] 29
244 The recipient number that was entered on the claim is eligible for Medicaid but not for this date of service. 141
246 The Other Carrier Amount (3rd Party) is greater than $0.00 and the Other Carrier Reason is missing. 17 MA92
250 The 12 digit Medicaid Recipient Number entered on the claim is not on the JFS eligibility file. 31 MA61
271 The recipient number that was entered on the claim is eligible for Medicaid but not for this date of service. 141
278 The Medicaid Recipient on the claim is a Qualified Medicare Beneficiary who did not qualify for full Medicaid. B5 N18
305 The service date entered on the claim form is over two years old. 29
322 The procedure code and/or revenue code billed is not covered by the Ohio Medicaid Program for the date of service billed. 96 M50
323 Recipient age is less than minimum on Diagnosis Master or greater than maximum age. 9
328 The procedure code which was billed is inappropriate for the recipient's age. Review the procedure code and recipient id that was entered on the claim for accuracy. 6
330 The procedure code billed is not covered by the Ohio Medicaid Program for the date of service billed. 96 N30
361 Recipient is on GA (General Assistance) or DA (Disability Assistance). 96 M67
598 All line item service dates occurred after the date of death listed on our recipient master file. 13
666 Although not an official ODJFS error code, this code will appear when "the amount requested from ODJFS" is not the same as "the amount paid by ODJFS." It usually appears when too many units are billed. 125 M54
730 On the first date of service the recipient is eligible for GA or DA and eligible for Medicaid on the last date of service or vice versa. Claim can not be priced when this condition exists. 141
927 PACE participants must obtain service through PACE provider. Providers must contract with PACE provider to obtain PACE reimbursement. 24 M115
992 Recipient enrolled in county GA program or invalid recipient ID submitted. 96 N30