Medicare and eClipse error codes

When Medicare reject or adjust the payment for a service they will include an exception code to explain the reason. Below is a list of return and exception codes from Medicare.

 

Click on the links below to refer to the Medicare or Department of Human Services websites in a new window

Medicare 3 digit rejection codes

Medicare 4 digit rejection codes

How to reduce claim rejections 

 

DVA rejection codes

3 digit return codes

101 More details of service required to assess benefit
102 No amount charged is shown on account/receipt
103 Letter of explanation is being sent separately
104 Balance of benefit due to claimant
105 Benefit paid to provider as requested
106 Servicing provider unable to be identified
107 Benefit paid on item number other than that claimed
108 Benefit is not payable for the service claimed
111 No benefit payable – claims/s over 2 years old
113 Total charge shown on account apportioned over all items
115 Benefit recommended for this item
117 Benefit not recommended for this item
120 Age restriction applies to this item
122 Associated referral/request line not required
123 Benefit paid on radiology item other than service claimed
124 Item is restricted to persons of opposite sex to patient
125 Not payable without associated operation/anaesthetic item
126 Service is not payable without radiology service
127 Maximum number of additional fields already paid  s
128 Benefit paid on associated fracture/amputation item
129 Service is not payable without the base item/s
130 Letter of explanation is being sent separately
131 Date of service not supplied/invalid
134 Single course of treatment paid as subsequent attendance
135 Provider not a consultant physician – specialist rate paid
136 Referral details not supplied- paid at g.p. rate
137 Details of requesting provider not shown on account/receipt
138 Benefit only payable when self-determined/deemed necessary
139 Approved pathologist should not use this item number
140 Non-specialist provider
141 No benefit payable for services performed by this provider
142 Letter of explanation is being sent separately
144 Claim benefit not paid – further assessment required
150 Member has not supplied details to permit claim payment
151 Associated service already paid-adjustment being processed
154 Diagnostic imaging multiple service rule applied to service
155 Letter of explanation is being sent separately
157 Service possibly aftercare – refer to provider
158 Benefit paid on associated abandoned surgery/anae item
159 Item associated with other service on which benefit payable
160 Maximum number of services for this item already paid
161 Adjustment to benefit previously paid
162 Benefit has been previously paid for this service
163 Surgical/anaesthetic item/s already paid for this date
164 Assistant surgeon benefit not payable
166 Letter of explanation is being sent separately
168 Not payable without associated operation/anaesthetic item
169 Operation/anaesthetic item not claimed
170 Assistant anaesthetic benefit not payable
171 Benefit not payable – provider may only act in one capacity
173 Patient episode coning – maximum number of services paid
174 Patient episode coning adjustment
175 Benefit paid on associated foetal intervention item
176 Pay each foetal intervention item as a separate item
177 Foetal intervention item paid using derived fee item
179 Benefit not payable – associated service already paid
184 Benefit paid for additional time item using a derived fee
194 Letter of explanation is being sent separately
195 Letter of explanation is being sent separately
206 Item number does not attract a benefit at date of service
208 Cardnumber used has expired
209 Claimants name stated is different to that on cardnumber
211 Patient not covered by this cardnumber at date of service
212 Date of service used is in the future
214 Claim form not complete
215 Service claimed prior 1 february 1984
217 Patient cannot be identified from information supplied
222 Benefit paid on associated anaesthetic item
223 Service not payable – specified item not claimed or present
225 Patient contribution substantiated-additional benefit paid
226 Date of service is prior to patients date of birth
227 Date of service prior to date eligible for medicare benefit
228 Date of service after benefit period for overseas visitor
229 Benefit paid at 100% of schedule fee
230 Combination of 85% and 100% of schedule fee paid
232 Service claimed not covered by medicare
233 Provider not entitled to medicare benefit at date of service
234 Letter of explanation is being sent separately
236 Letter of explanation is being sent separately
237 Letter of explanation is being sent separately
238 Not paid because all associated services rejected
240 Gap adjustment to benefit previously paid
241 Total charge and benefit for multiple procedure
242 Service is part of a multiple procedure
243 Apportioned charge and total benefit for multiple procedure
244 Benefit not paid – service line in error
245 Benefit paid on service other than that claimed
246 Patient cannot be identified from information supplied
250 Explanation/voucher will be forwarded separately
251 Details of requesting provider not supplied
252 Service possibly aftercare
253 Radiotherapy assessed with other item number on statement
254 Assessment incomplete – further advice will follow
255 Benefit assigned has been increased
256 Benefit not payable on this service for a hospital patient
260 Benefit assessed with associated item on statement
261 Associated surgical items/anaesthetic time not supplied
262 Insufficient prolonged anaesthetic time – service not paid
264 Benefit not payable – compensation/damages service
265 Service not covered by reciprocal health care agreement
267 Service not payable – associated service not present
271 Not payable without associated ophthalmological item
272 Benefit paid on associated ophthalmological item
274 Provisional payment
280 Cannot identify service. resubmit with correct mbs item
282 Date of service outside of referral/request period
306 Card# not valid at date of service-future claims may reject
307 Claim not paid – cardnumber not valid for date of service
308 Ivf service – conditions not met – no benefit payable
316 Benefit not payable – item cannot be self-determined
317 Benefit not payable – additional item to those requested
320 Quoted medicare cardnumber is incorrect
322 Provider not approved for this medicare pathology benefit
325 Laboratory not accredited for benefits for this service
326 Laboratory not accredited for benefits at date of service
328 Benefit paid on associated tomography item
329 Not payable without associated tomography item
331 Benefit not payable – h.i. act sect 20(a)(1)
332 Category 5 lab – benefit not payable for requested service
333 Provider must claim time-based items
334 Benefit not payable-associated pathology must be inpatient
335 Service is not payable without nuclear medicine service
336 Benefit paid on nuclear medicine item other than one claimed
337 Provider must claim content-based items
338 Provider not registered to claim benefit at date of service
339 Benefit paid at the concession rate
340 Refund of co-payment amount
341 No referral details – details required for future claims
342 Referral expired – paid at unreferred (gp) rate
343 Cardnumber quoted on claim form has been cancelled
344 Concession number invalid – benefit paid at general rate
345 No safty net entitlement – benefit paid at general rate
346 Co-payment not made – $2.50 credited to threshold
347 Safety net threshold reached – benefit increased
348 Overpayment of claim – invalid concession number
349 Replacement for requested eft payment rejected by bank
350 Hospital referral – paid at specialist/consultant rate
351 Benefit not payable – lcc number incorrect or not supplied
352 Service date outside lcc registration dates
353 Pathology items not present – no benefit payable
356 Documentation required to process service
358 Documentation not received – unable to process service
359 Documentation not received – unable to process claim
360 No benefit payable when requested by this provider
361 Di exemption/items not approved
364 Items claimed must be as a combination item
367 Service associated with mbac item in a multiple procedure
370 Benefit paid on item number other than that claimed
371 Future claims quoting old style card no. will be rejected
372 Old style card number quoted – benefit not payable
373 Expired card – benefit not payable
374 Old card issue used – benefit not payable – also refer @
375 Service being processed manually
377 Number of patients seen not indicated
378 Provider cannot refer/request service at date of request
390 Documentation not received
391 Service provider on db1 differs from transmitted data
392 Benefit amount changed
393 No benefit payable – baby not an admitted inpatient
395 Tac medical excess
400 Equipment number missing or invalid
401 Benefit not payable – charge amount missing or invalid
402 Benefit not payable- number of patients attended required
403 Subsequent consultation – referral details required
404 Benefit not payable – referral/request details required
405 Equipment number invalid for servicing provider
406 Unable to assess claim – please forward documents
407 Benefit not payable – overseas student
408 Date of service prior to 29 may 1995
409 Cardnumber for this enrolment needs to be verified
410 Age restriction applies for this item – verify details
411 Mbac determination/precedent number not supplied or invalid
412 Benefit not payable – provider unable to claim this service
413 Benefit not payable – date of serv prior to date of request
414 Provider practice location is closed at date of service
415 Referral details same as rendering provider – self-deemed?
416 Services form a composite item – composite item required
417 Referral needed – if no referral, nr item to be transmitted
418 Item cannot be claimed more than once in one attendance
419 Benefit already paid on item – verify if multiple pregnancy
420 Operation/s schedule fee does not meet item description
421 Wrong assistant item used for the operation/s performed
422 Benefit paid has been reduced (benefit = charge)
423 Optical condition not specified – no benefit payable
424 More information required – which eye was treated
425 Benefit not payable – individual charges required
426 Indicate whether new treatment or continuing management
427 Compensation related services – please forward documents
428 Date of service over 2 years – late lodgement form required
429 Patient cannot be identified from the information supplied
430 Conflicting referral details – please clarify
431 Initial consultation previously paid – query subsequent con
432 Not multi-op – more information required to pay benefit
433 Associated referral/request line not required
434 Expired or invalid card.  benefit not payable
435 Service for nursing home care recipient – benefit not paid
436 Cannot claim out of hospital service through simplified bill
450 Eft details invalid – cheque issued for benefit
461 Adjustment to benefit previously paid
475 Patient/service details invalid or missing
500 Rejected in association with another item in this claim
501 Group attendance or item format invalid
502 Patient is not eligible to claim benefit for this item
503 Referral date format is invalid
504 Charge amount missing/invalid – no benefit payable
505 More information required. evidence of condition
507 Site not accredited for this service
509 Service paid as item 2712/2719
510 Service paid as item 52-96/or similar item
511 Emsn threshold reached – cap applied to benefit
512 Multiple musculoskeletal mri service rule applied
513 Multiple musculoskeletal mri and di services rules applied
514 Required equipment type code not on lspn register
515 Equipment is older than allowable age for this item
516 Ben paid for base and derived radiotherapy items claimed
517 Mpsn threshold reached – 80% out of pocket paid
518 Benefit paid at 100% schedule fee + emsn
519 Mpsn threshold reached – partial 80% out of pocket paid
520 Benefit paid at 100% schedule fee + part 80% out of pocket
521 Paid part 80% out of pocket + between 85% and 100% increase
522 Benefit paid – emsn + between 85% and 100% schedule fee
524 Safety net benefit adjusted
525 Only attracts benefit when claimed via bulk billing
528 Provider not in eligible area (incorrect rrma,ssd or state)
529 Bulk bill additional item claimed incorrectly
530 Patient not on concession/under 16 years at date of service
535 Missing data
536 Location specific practice number not supplied
537 Location specific practice number invalid
538 Location specific practice number not recognised
539 Location specific practice number not valid at date of serv
540 Enhanced primary care plan item not previously claimed
549 Bulk bill incentive item already paid – adjustment required
550 Associated service not claimed – no benefit payable
551 Specimen collection point is incorrect or not supplied
552 Specimen collection point not valid at date of service
553 Approved collection centre number not supplied
554 Total benefit for anaesthetic service
555 Benefit paid on main rvg anaesthetic item
556 Rvg time item not claimed
557 Associated rvg anaesthetic service not claimed
558 Rvg anaesthetic item not claimed
559 Patient outside age range – please verify age
560 Rvg item restriction
561 Benefit paid on rvg item claimed
562 Benefit paid on associated rvg anaesthetic item
563 Associated rvg service already paid
564 Multiple vascular ultrasound services site rule applied
565 Multiple di and vascular ultrasound service rules applied
566 Total benefit for diagnostic imaging service
567 Benefit paid on main diagnostic imaging item
600 Requesting/referring provider unable to be identified
601 In hospital services cannot be claimed as out of hospital
602 Out of hospital service cannot be claimed as in hospital
603 Newborn not yet enrolled with medicare – no benefit payable
604 Service over 6 months old – late lodgement form required
605 Referral expired – no benefit payable
606 Referring provider number not open at date of referral
607 Referral date has been omitted
608 Referring and servicing provider same – no benefit payable
609 Service cancelled at providers request
610 Provider specialty not consistent with item claimed
611 Referral/request details not supplied – no benefit payable
612 Date of referral after date of service – no benefit payable
613 Card number cannot be identified from information supplied
614 No benefit payable – please notate time of each visit
615 Multiple procedures – notate times and area of treatment
616 Item cannot be claimed as in hospital service
617 Item cannot be claimed as out of hospital service
618 No benefit if requested by this provider at date of request
619 Servicing provider number not open at date of service
620 Duplicate transmission – no further payment made
621 Item not claimable electronically
622 Pet drop-down items not claimable via edi
623 Pet items only claimable via direct bill
624 Pet items – payee provider required
625 Payee provider not eligible to claim pet items
627 Pdt statement not provided by the doctor
629 Initial pdt therapy item not present on patient history
633 Refer back to the specialist (referring provider is closed)
634 Refer back to the specialist (servicing provider is closed)
635 Late lodgement not approved – letter being sent separately
636 Benefit reduced-dental cap broken
637 No benefit payable-dentalcap reached
638 Derived fee and other item cannot be claimed in-hospital
639 Provider not in an eligible area to claim this item
640 More than one base and derived item claimed
641 More than one base item claimed
642 Benefit paid for derived and other item claimed
643 Derived item assessed with other item on statement
654 Item transmitted via incorrect online claiming channel
700 Benefit cannot be determined for this service
701 Benefit cannot be determined due to complex assessing rules
702 Item restrictive with another item
703 Duplicate of item already quoted
704 Provider not permitted to claim this item
705 No associated pathology service
706 Provider not associated with a pathology laboratory
707 Pathology laboratory not registered at date of service
708 Item cannot be claimed from this pathology laboratory
709 Another assistant item should be claimed
710 Associated surgical items not present
711 Unable to determine associated surgery
712 Base item not present or in incorrect order
713 Radiotherapy fields greater than maximum allowable
714 Benefit not determined – number ot time units not present
715 Number of time units exceeded maximum allowable
716 Service forms a composite item – composite item required
717 Benefit not payable on this service for a hospital patient
718 Provider location not open at date of service
719 Benefit cannot be calculated for hyperbaric oxygen therapy
720 Eligibility cannot be determined for this item
732 Referral period not valid for referring provider

4 Digit return codes

 

1001 Unable to load /connect to Java Virtual Machine.
1002 Unable to unload Medicare Online Claiming.
1003 Medicare Online Claiming is not operational.
1004 A session could not be established.
1005 No session matching the provided session ID currently exists.
1006 PKI login failure.
1007 Transmission failure.
1008 Medicare Online Claiming already operational
1010 Medicare Online Claiming session already exists
1011 Unable to find Java Virtual machine library
1012 The CLASSPATH environment variable cannot be found
1013 Unable to locate the base Java Classes
1014 Unable to locate the EasyclaimAPI class
1015 Create Cryptostore failure
1016 Config file not found, cannot be opened or file type incorrect. Check path.
1017 Config file already loaded. No action taken
1018 Config parameters does not exist or not defined for this DLL version
1019 Config parameter cannot be set as Medicare Online Claiming already operational (ie. loadEasyclaim already called)
1701 Sql failure
1702 XML to JAVA classes conversion failure
1703 Client Adaptor session does not exist
1704 Desecure failure
1705 Secure failure
1711 Unexpected protocol exception
1712 HTTP server error
1713 Protocol error
1714 Error occurred attempting to load logic pack
1715 The added content was created with a LogicPack with a different major and minor version therefore it cannot be loaded
1716 Request received, process in progress
1717 No logic packs have been loaded
1718 No further reports exist in session
1719 No unloadable content exists in session
1720 Unknown content type OR problem with configuration preventing ContentInfo lookup
1721 Development mode not supported by this ContentInfo OR retrieval of dev content failed
1722 Intermittent problem signing using the HCI token. Repeating the function call should be successful
1723 The receiver has rejected this asynchronous response and will not accept it at any future time. The sender should take whatever action is appropriate to reverse the transaction that generated the response.
1724 The receiver is unable to accept this asynchronous response at this time – the sender should attempt to deliver the response at a later time
1725 Inconsistent search criteria has been set
1726 The Business Process Manager has been unable to accept the claim request due to an unknown error
1727 Response received
1728 An undetermined error has occurred processing the request in the BPM
1997 An attempt to call an unsupported function was made
1998 An undefined error has been detected in C DLL
1999 An undefined error has been detected in Java API
2001 A claim is in progress and cannot be modified
2002 Missing or invalid transmission content type
2003 No transmission exists
2004 The element name supplied is not valid or does not apply to the current function
2005 No authorised claim exists within the specified session
2006 A claim or request already exists. Another claim or request cannot be created until the current claim or request is cancelled or completed.
2007 The transmission is empty i.e. the transmission does not contain any content
2008 No business object currently exists for the supplied Session ID
2009 The condition name supplied is not valid
2010 The claim type is not valid
2011 The information being set is inconsistent with the information currently set for this claim
2012 Transmission in progress. The requested action cannot be done until the current transmission is sent or cancelled.
2013 A report is in use. The existing report must be cleared before a claim or transmission can be created.
2014 The current claim has already been processed (submitted or accepted). Get details then clear the claim
2015 No voucher exists within the session for the supplied VoucherSeqNum
2016 No service exists in the claim for the supplied service ID
2017 The Payee Provider specified is the same as the Servicing Provider
2018 Data validation, cross field validations or unacceptable errors have been detected and not corrected OR data has been changed and not validated before submission. Correct any errors and resubmit.
2019 An object with the supplied object ID already exists
2020 Invalid file path type
2021 Invalid directory or directory not found
2022 The report name supplied is not valid
2023 The report is not available yet or is no longer available for retrieval
2024 A voucher with the quoted sequence number already exists in the claim/session
2025 The maximum number of child business objects for the parent business object type has been reached
2026 An out of sequence function call has occurred
2027 The report does not exist for the given selection criteria
2028 The requested clear would have removed the last voucher from the claim. The claim requires at least one voucher to be present.
2029 This function does not apply to the current report
2030 The data element being set is inconsistent with other data elements already set OR a data element has been set and a related conditionally required data element has not been set.
2031 The claim contains an unacceptable error that must be corrected prior to submission/storage
2032 The maximum number of services allowable for the voucher has been reached
2033 The maximum number of services allowable for the claim has been reached
2034 The OutputBuffer allocated is too small for the data being retrieved
2035 The function requested is inconsistent with the current state of processing
2036 The current claim must be completed (submitted, accepted or authorised and stored) or cancelled
2037 An error was detected with the voucher sequencing. The sequence numbers must begin with 01 and increment by one as each voucher is added.
2038 The referral/request type is inconsistent with the service type set for this claim
2039 Invalid service ID
2040 The claim or request data received by the Client Adaptor from the client system is incomplete or missing
2041 Record Sequence Number is invalid
2050 Unable to map specified PathOfObject to an existing business object
2051 The position of the business object in the hierarchy of business object types is invalid
2052 This method is not supported by the type of content you are creating Click here for more information
2053 Patient contribution amount must be less than total charge
2054 Date of service is inconsistent with other dates set
2055 Patient contribution amount should not be set when the account is fully paid
2056 The supplied discharge date must not be earlier than the admission date
2057 Instances of admission date, discharge date, care plan issue date or clinical condition treated reason date cannot be earlier than date of birth.
2058 Expected high level object missing
2059 The part number must be less than or equal to the part total
2060 Text for requested return code not found. Either the Medicare CA ErrorList.properties file not found or is out of date.
2064 A CID segment must be supplied
2065 A PAT segment must be supplied
2066 An EPD segment must be supplied
2067 Number of days of Palliative Care must be supplied
2068 Where ContiguousClaimCde = N or L then at least one MOR segment must be created and all conditional data elements set at least once except where PatientClassificationCode = RE
2070 The only special character allowed in ANSNAPId is a hyphen
2071 If PatientClassificationCode=PS then TotalPsychiatricCareDays must be set
2072 TotalPsychiatricCareDays must be in the format NNNNN
2073 PalliativeCareDays must be in the format NNNN
2074 NumberOfQualifiedDaysForNewborns must be in the format NNNNN
2075 NonCertifiedDaysOfStay must be in the format NNNN
2076 NumberOfHours must be in the format NNNN
2077 MultiDisciplinaryRehabPlanDate must be in the format DDMMYYYY
2078 DischargePlanDate must be in the format DDMMYYYY
2999 An error has been detected whilst executing a function within the Client Adaptor
3001 Communication error. Check that you have a current internet session. For further assistance contact the Medicare eBusiness Service Centre.
3002 The response from the central site was not received within the permitted response time.
3003 The Medicare server is not operational. Try again later. If the problem persists, contact the Medicare eBusiness Service Centre.
3004 The request cannot be dealt with at this time because real-time processing is not available or the system is down. Contact the Medicare eBusiness Service Centre for further assistance.
3005 The message format received by the Client Adaptor was not valid (PKI)
3006 The message could not be decrypted. Contact the Medicare eBusiness Service Centre for further assistance.
3007 The Client Adaptor could not decrypt the return message. Contact the Medicare eBusiness Service Centre for further assistance.
3008 The sending Location could not be identified at the Client Adaptor
3009 The Medicare signing certificate could not be found in the PSI store OR the passphrase used did not match the Individual certificate. If problem persists contact the Medicare eBusiness Service Centre.
3010 The data has been corrupted in transmission
3011 The transmission received at the Client Adaptor was not encrypted.
3012 The message received at the Client Adaptor was not signed. Messages should be signed by the sending Location.
3013 The signing Location is unknown. For further assistance contact the Medicare eBusiness Service Centre.
3014 The internal message format is invalid. Contact the Medicare eBusiness Service Centre for further assistance.
3015 The response could not be secured. Contact the Medicare eBusiness Service Centre for further assistance.
3016 The supplied location ID does not match the HCL For further assistance contact the Medicare eBusiness Service Centre. [No longer used]
3017 The transmission date is not the current date. Check the system date set in the transmitting computer.
3018 Data content of the message received by the Client Adaptor is unrecognisable
3019 Data content of the message received by the Client Adaptor is missing or exceeds the maximum allowable size
3020 The message format received at the Server was not valid (PKI). Contact the Medicare eBusiness Service Centre for further assistance.
3021 The sending Location could not be identified at the Server. Contact the Medicare eBusiness Service Centre for further assistance.
3022 The data arriving at the Server has been corrupted in transmission. Contact the Medicare eBusiness Service Centre for further assistance.
3023 The transmission arriving at the Server was not encrypted
3024 The message arriving at the Server was not signed
3025 The internal format of the message arriving at the Server is invalid. Possible cause: non standard characters in a patient’s name. Contact the Medicare eBusiness Service Centre for further assistance.
3026 Data content is unrecognisable at the Server. Contact the Medicare eBusiness Service Centre for further assistance.
3027 Data content of the message arriving at the Server is missing or exceeds the maximum allowable size
3028 HTTP 1.0 response code 202 returned
3029 HTTP redirection attempted
3030 HTTP client error
3031 The server cannot fulfil this request
3032 Bad Gateway encountered
3033 Duplicate Claim IDs. More than two (2) claims have been submitted with the same Claim ID. Contact the Medicare eBusiness Service Centre for further assistance.
3034 An invalid object ID has been supplied
3035 The type of claim being transmitted or received cannot be identified
3036 The sending Location’s details failed validation against the Registration File. Contact the Medicare eBusiness Service Centre for further assistance.
3037 The sending Individual’s details failed validation against the Registration File. Contact the Medicare eBusiness Service Centre for further assistance.
3038 Authentication failed at proxy server. Session element AuthProxyName contains proxy name at which failure occurred. Set AuthProxyUserId and AuthProxyPasswd to provide authentication at the proxy.
3039 An error occurred during transmission to Medicare. It is unknown whether the claim was processed. Contact the Medicare eBusiness Service Centre.
3040 Health Fund system unavailable
3041 Test transmissions are not supported for this business function at this time
3042 Health Fund cannot accept this claim. Please contact the Health Fund for assistance.
3043 The TransactionId of the submitted ERA has previously been received by the HUB
3999 An undefined error was detected either preparing the transmission, during transmission or at the Medicare central site
5001 The quoted Individual Certificate RA number is registered to another individual
5002 One or more of the Professional Number Stems quoted is registered to another individual
5003 Professional Number Stem(s) must be supplied
5004 Action type must be supplied
5005 Subscription ID must be supplied
5006 Valid state code must be supplied
5007 The subscription ID supplied is not registered.
5008 The Registration already exists
5009 Name required. At least one of surname or first name must be supplied.
5010 The subscription ID supplied has been identified as in-active
5011 Update request received where existing record has old subscriber version (V1R0) . Need to be a insert request.
5201 Duplicate claim at Health Fund
5202 The Health Fund system has reached capacity
7001 Service Rate must be supplied.
7002 The Hospital Indicator must be set.
7003 Pre-Existing Ailment (PEA) Indicator must be supplied.
7004 The Funds’ Universal Patient Identifier (UPI) must be supplied.
7006 A Service Id is missing and must be supplied.
7007 Co-payment description must be set.
7008 Excess amount description must be supplied.
7009 Claim assessment code required.
7010 Service Assessment Code must be supplied.
7011 Element Name must be supplied.
7012 Inpatient Medical Claims can process up to 50 services within one claim. Please divide the services appropriately and re-submit.
7013 Provider is not registered at the transmitting Location for IHC DVA
7014 Service Code or Item Number for IHC DVA cannot be more than 5 characters
7015 Accommodation Total must equal sum of Accommodation Charge amounts for IHC DVA
7016 Accommodation Total Days must equal sum of Accommodation Item Days for IHC DVA
7017 Accommodation Total Leave Days must equal all Leave Period Leave Days (IHC DVA)
7018 Service or Item From Date cannot precede Accomm Summary From Date (IHC DVA)
7019 Service or Item To Date cannot be later than Accom Summary To Date (IHC DVA)
7020 Please split the Item into parts with less than 99 days (IHC DVA)
7021 Total Amount must equal sum of Principle and Multiple Service Amounts (IHC DVA)
7022 Certificate cannot span calendar years. Split into calendar years (IHC DVA)
7023 Item cannot span calendar years. Split into separate calendar years (IHC DVA)
7024 IHC DVA does not support Adjustments
7025 Service or Item Charge Amounts over $99999.99 are not supported by IHC DVA
7026 DVA file number does not have a Gold or White card and may not be eligible for services. Please verify file number and resubmit claim.
7027 Public Hospitals can only claim prosthesis charges at this time.
7028 Name does not match registered name for File Number.
7029 IHC DVA does not support over 400 services or vouchers in a transmission
7030 IHC DVA can’t have over 80 vouchers in a transmission. Split claim and resubmit
7031 Transmitting Location not registered for DVA. Contact eBusiness 1800 700 199
7032 The Total Charge cannot include non Hospital Charges for IHC DVA
7033 Invalid Provider Number for IHC DVA
7034 IHC DVA claims are not accepted from Public Hospitals at present
7035 Patient gender must be Male or Female for IHC DVA
7036 Service or Item From Date for IHC DVA cannot be later than the Date of Lodgement
7037 Claim Certified Ind missing (this may apply where certification details are implicitly set as part of a business object)
7038 ClaimCertifiedDate and ClaimCertifiedInd are missing
7039 ADLTransferMobilityInd is missing or invalid value has been set
7040 AcceptedDisabilityText is missing
7041 ReferralIssueDate is inconsistent with the ServiceTypeCde and/or other data elements set
7042 ReferralOverrideTypeCde is inconsistent with the ServiceTypeCde and/or other data elements set
7043 ReferringProviderNum is inconsistent with the ServiceTypeCde and/or other data elements set
7044 RequestIssueDate is inconsistent with the ServiceTypeCde and/or other data elements set
7045 RequestOverrideTypeCde is inconsistent with the ServiceTypeCde and/or other data elements set
7046 RequestingProviderNum is inconsistent with the ServiceTypeCde and/or other data elements set
7047 HospitalInd is inconsistent with the ServiceTypeCde and/or other data elements set
7048 ReferralIssueDate is prior to patient date of birth
7049 ReferralIssueDate is after the date of service
7050 RequestIssueDate is prior to patient date of birth
7051 ReferralOverrideTypeCde must be set or referral details must be set
7052 ReferralPeriod is inconsistent with the ServiceTypeCde and/or other data elements set
7055 TreatmentLocationCde is inconsistent with the ServiceTypeCde and/or other data elements set
7056 CollectionDateTime is inconsistent with the ServiceTypeCde and/or other data elements set
7057 AccessionDateTime is inconsistent with the ServiceTypeCde and/or other data elements set
7058 AccessionDateTime is earlier than RequestIssueDate
7059 ADLToiletingContinenceInd is missing or invalid value has been set
7060 AfterCareOverrideInd cannot be set when ServiceTypeCode is set as Pathology, Diagnostic or Radiotherapy
7061 DuplicateServiceOverrideInd is inconsistent with the ServiceTypeCde and/or other data elements set
7062 EquipmentId is inconsistent with the ServiceTypeCde and/or other data elements set
7063 FieldQuantity is inconsistent with the ServiceTypeCde and/or other data elements set
7064 ItemNum must be set to KM or OT80 where DistanceKms is set
7065 LSPNum is inconsistent with the ServiceTypeCde and/or other data elements set
7066 MultipleProcedureOverrideInd is inconsistent with the ServiceTypeCde and/or other data elements set
7067 NoOfPatientsSeen is inconsistent with the ServiceTypeCde and/or other data elements set
7068 Rule3ExemptInd is inconsistent with the ServiceTypeCde and/or other data elements set
7069 S4b3ExemptInd is inconsistent with the ServiceTypeCde and/or other data elements set
7070 SCPId is inconsistent with the ServiceTypeCde and/or other data elements set
7071 DistanceKms is missing
7073 DistanceKms is set where no other service exists within the voucher
7074 DistanceKms is set and the date of service is not consistent with another service item present in the same voucher
7075 DistanceKms is set with ChargeAmount
7076 ItemNum = KM and ChargeAmount has been set
7077 ItemNum = KM, DistanceKms and ChargeAmount have all been set
7078 ItemNum is set to KM or OT80 but DistanceKms has not been set
7079 DistanceKms is set and ItemNum = KM has not been set
7080 NumberOfServices is inconsistent with the ServiceTypeCde and/or other data elements set
7081 ADLPersonalHygieneInd is missing or invalid value has been set
7082 NumberOfServices is not a valid value
7087 ADLEatingInd is missing or invalid value has been set
7088 ADLCognitiveBehaviouralInd is missing or invalid value has been set
7093 NoOfPatientsSeen is not a valid value for TreatmentLocationCde
7094 RequestIssueDate a future date
7095 DateOfService is in an invalid value
7096 ADLTool is missing or invalid value has been set
7097 LivesAloneInd is missing or invalid value has been set
7098 CarerInd is missing or invalid value has been set
7099 BreakInEpisodeOfCare is missing or invalid value has been set
7100 RestrictiveOverrideCde can only be set when ClaimTypeCde is set to PC
8001 No more claims exist within the report
8002 No more rows exist within the report
8003 Patient is currently ineligible for Medicare. This status can be confirmed for today only.
8004 The report requested contains too much data to be returned. Try more specific selection criteria
8005 The individual has been matched using the submitted data however differences were identified. Please check the information returned and update your records.
8006 Claim accepted however Medicare patient validation outstanding. – This return code will be deleted [LW]
8007 Membership matched. Please ask patient to contact the Fund
8008 Membership matched but provider must contact the Fund
8009 The name supplied for this individual differs from that held by Medicare. This individual only has one name. Please check the name and update your records.
8010 The request has not been completed within the allocated time frame
8011 The report contains header information only
8012 Details for a POTENTIAL match with DVA records have been returned. Please check this information with the Veteran and, if correct, update your records
8013 Veteran identification confirmed however their card type could not be determined. Please contact DVA.
8014 Claim accepted for processing. Updated information has been supplied
9001 The Location is not authorised to undertake Online Claiming transactions. The transmission has been rejected. Contact the Medicare eBusiness Service Centre for further assistance.
9002 The individual signing the claim or making the request is not authorised to undertake Online Claiming transactions. The claim has been rejected. Contact the Medicare eBusiness Service Centre for further assistance.
9003 The provider is identified as inactive for Online Claiming purposes. Contact the PKI Customer Service Centre for assistance.
9004 Only test transmissions are acceptable from this location at this time. Contact the Medicare eBusiness Service Centre for further assistance.
9005 The signature (HCI) is not that of the Servicing Provider
9006 The Provider is not authorised to participate in Online Claiming. Contact the Medicare eBusiness Service Centre for further assistance.
9007 The Location is not authorised to undertake the function on the date of transmission. The transmission has been rejected. Contact the Medicare eBusiness Service Centre for further assistance.
9008 Claims from this provider must be signed using their Individual Certificate
9009 This transaction type is not permitted from this type of client
9010 The software product used to create the transaction is not certified for this function. Contact the Medicare eBusiness Service Centre for further assistance
9011 Billing Agent is not recognised as belonging to the transmitting Location
9012 The intended recipient is unable to accept this content type at this time
9013 Hospitals can only submit eligibility checks relating to their hospital
9014 The requestor is identified as a Billing Agent. Billing Agents can only submit eligibility checks using their Billing Agent identifier
9015 StartDateBreakInEpisode is missing or invalid value has been set
9016 StartDateBreakInEpisode cannot be set where BreakInEpisodeOfCare is set to 4 or 5
9017 EndDateBreakInEpisode must be set where BreakInEpisodeOfCare is set to 1, 2 or 3
9018 EndDateBreakInEpisode is missing or invalid value has been set
9019 NumberOfCNCVisits is missing or invalid value has been set
9020 NumberOfRNVisits is missing or invalid value has been set
9021 NumberOfENVisits is missing or invalid value has been set
9022 NumberOfNSSVisits is missing or invalid value has been set
9023 NumberOfCNCHours is missing or invalid value has been set
9024 NumberOfRNHours is missing or invalid value has been set
9025 NumberOfENHours is missing or invalid value has been set
9026 NumberOfNSSHours is missing or invalid value has been set
9027 Community Nursing Minimum Data Set elements cannot be set unless ServiceTypeCde is set to F
9028 StartDateBreakInEpisode must be before or equal to EndDateBreakInEpisode
9029 ClaimCertifiedInd must be set to Y to submit the claim
9030 EndDateBreakInEpisode cannot be set where BreakInEpisodeOfCare is set to 4 or 5
9101 Invalid Passphrase. The Passphrase entered does not match the passphrase for this Location certificate.
9102 The Location Certificate (HCL) has expired. Contact the Registration Authority.
9103 The token relating to the individual certificate could not be found
9104 The Individual Certificate (HCI) has expired
9105 Invalid certificate type. The certificate type is either location or individual
9106 Could not change passphrase. Ensure original passphrase entered is correct, the new passphrase differs from the old passphrase and that the new passphrase conforms to passphrase requirements.
9107 The private keys specified could not be imported. Please check the input filenames. If the problem persists call the Medicare eBusiness Service Centre
9108 The Medicare Public Certificates could not be imported. Please check the input filenames. If the problem persists call the Medicare eBusiness Service Centre.
9109 One or more of the specified files could not be accessed. Please ensure the filenames are correct, and you have read access to them
9110 Could not create one or more destination files. Please ensure you have write access to the destination directory and sufficient space available
9111 If createCryptoStore – a PSI Store already exists in the nominated folder. Otherwise a problem has been encountered using PKI services. Repeating the function call should be successful
9112 Location signing Certificate not found in the PSI Store.
9113 Individual signature not required
9114 Individual signature is optional
9115 The Location Certificate used has been revoked by the Registration Authority. Please contact the PKI Customer Service Centre
9116 The Location Certificate used differs from the Certificate recorded for this Location. Contact the Medicare eBusiness Service Centre for assistance.
9117 The Location Certificate used cannot be used for the requested function. Contact the Medicare eBusiness Service Centre for assistance.
9118 The Location has been identified as inactive. Contact the Medicare eBusiness Service Centre for assistance.
9119 The provider is identified as inactive for Online Claiming purposes. Contact the PKI Customer Service Centre for assistance.
9120 The Individual Certificate used has been revoked by the Registration Authority. Contact PKI Customer Service Centre for assistance.
9121 Desecure failure at Medicare. Contact the PKI Customer Service Centre for assistance
9122 Location Id missing from transmission
9123 The HCL Certificate used to sign the transmission is not the Certificate currently registered against the Location Id
9124 Unable to determine the Location Id from the submitted data. Please contact the Medicare eBusiness Service Centre for assistance.
9125 Cannot register Location based on transaction type
9126 No current Location Certificate exists in the nominated PSI Store
9127 Requested Location Encryption Certificate not found in the PSI Store
9128 MultipleProcedureOverrideInd is an invalid value
9129 NoOfPatientsSeen is not a valid value
9130 NumberOfPatientsSeen cannot be set when MultipleProcedureOverrideInd is set
9131 NumberOfPatientsSeen is not a valid value if the RequestOverrideTypeCde is set
9132 Rule3ExemptInd is an invalid value
9133 S4b3ExemptInd/S4B3ExemptInd is an invalid value
9134 SCPId is an invalid value
9135 ServiceId is an invalid value
9136 TimeOfService is an invalid value
9137 DateOfService is a date in the future
9138 AccessionDateTime is earlier than RequestIssueDate
9139 CollectionDateTime is later than RequestIssueDate
9140 SelfDeemedCde is an invalid value
9141 SelfDeemedCde is inconsistent with the ServiceTypeCde and/or other data elements set
9142 The value in the Restrictive Override Code is invalid, please check and resubmit your claim
9144 TimeOfService must be set if either DuplicateServiceOverrideInd or MultipleProcedureOverrideInd or both are set to Y
9145 DistanceKMS is inconsistent with ServiceTypeCde and/or can’t be set with MultipleProcedureOverrideInd, DuplicateServiceOverrideInd, Rule3ExemptedInd, S4B3ExemptInd, TimeOfService, SCPId, CollectionDateTime,AccessionDateTime,FieldQuantity,LSPNum,EquipmentId
9146 AuthorisationDate is missing
9147 DistanceKMs cannot be set when TreatmentLocationCde is set to R
9193 CollectionDateTime is earlier than RequestIssueDate
9201 Invalid format for data item
9202 Invalid value for data item. The data element does not comply with the values permitted or has failed a check digit check.
9203 Date of service must be no more than 2 years in the past
9204 Date in future. The date supplied must not be in the future
9205 Requested data item is empty.
9206 Date must be in the future. The date supplied is expected to be a future date
9207 An item cannot be self deemed or substituted when a referral or request override has been set
9208 Date supplied too old
9209 Date supplied is greater than 12 months in the future
9210 Date of service must be no more than two years in the past
9211 Future date-time. Date-time cannot be in the future
9212 ServiceId is not set
9214 Transaction Id not a valid value
9215 Authorisation date is an invalid value (this may apply where Authorisation date is explicitly set)
9217 Authorisation date is a date in the future
9218 Authorisation date more than 2 years past
9219 VeteranFileNum is a mandatory field and must be provided
9220 Payee Provider Number is not a valid value
9221 Claim Certified Ind not a valid value (this may apply where Authorisation date explicitly set)
9222 Claim Certified date is an invalid format. (this may apply where Authorisation date explicitly set)
9223 Claim Certified date is an invalid value. (this may apply where Authorisation date explicitly set)
9224 Claim Certified date must not be a future date (this may apply where Authorisation date explicitly set)
9225 Claim Certified date more than 2 years past
9226 PatientDateOfBirth more than 130 years ago
9227 PatientDateOfBirth is later than Date of Service
9228 AcceptedDisabilityInd is an invalid value
9229 AcceptedDisabilityText set but AcceptedDisabilityInd not set to Y
9230 AcceptedDisabilityText is an invalid value
SPARE SPARE CODE
9232 PatientAddressPostcode is an invalid value
9233 PatientAliasFamilyName is an invalid value
9234 PatientAliasFirstName is an invalid value
9236 PatientFamilyName is an invalid value
9237 PatientFirstName is an invalid value
9244 PatientAddressLocality is an invalid value
9245 PatientAddressPostcode is an invalid value
9246 PatientDateOfBirth is an invalid value
9247 PatientGender is an invalid value
9248 ReferralIssueDate is an invalid value
9249 ReferralPeriodTypeCde is an invalid value
9250 ReferralOverrideTypeCde is an invalid value
9251 ReferringProviderNum is an invalid value
9252 RequestingProviderNum is an invalid value
9253 RequestIssueDate is an invalid value
9254 RequestOverrideTypeCde is an invalid value
9255 ServiceTypeCde is an invalid value
9256 ServicingProviderNum is an invalid value
9257 HospitalInd is an invalid value
9258 VeteranFileNum is an invalid value
9259 VoucherId is an invalid value
9260 PatientDateOfBirth in the future
9263 ReferralPeriod is an invalid value
9270 HospitalInd is not a valid value for TreatmentLocationCde
9271 TreatmentLocationCde is an invalid value
9273 AccessionDateTime is a future date-time
9274 CollectionDateTime is a date-time in the future
9275 AccessionDateTime is an invalid value
9277 AfterCareOverrideInd is an invalid value
9278 ChargeAmount cannot be set where DistanceKms is set
9279 PatientDateOfBirth is an invalid value
9280 ReferralIssueDate is an invalid value
9283 RequestIssueDate is an invalid value
9286 TimeOfService is an invalid value
9288 ServiceText is an invalid value
9290 AccountReferenceNum is an invalid value
9291 ChargeAmount is an invalid value
9292 CollectionDateTime is an invalid value
9293 DateOfService is an invalid value
9294 DistanceKms is an invalid value
9295 DuplicateServiceOverrideInd is an invalid value
9296 EquipmentId is an invalid value
9297 FieldQuantity is an invalid value
9298 ItemNum is an invalid value
9299 LSPNum is an invalid value
9301 Patient’s Medicare card number must be supplied
9302 Patient’s reference number must be supplied
9303 Patient’s first name must be supplied
9304 Patient’s family name must be supplied
9305 Servicing Practitioner’s Provider Number must be supplied
9306 Date of service must be supplied
9307 An item number must be supplied for each service
9308 Referring Practitioner’s Provider Number must be supplied
9309 Referral issue date must be supplied, and must be prior to, or the same as, the date of the medical service, cannot be before the date of birth, nor after the referral start date
9310 Requesting Practitioner’s Provider Number must be supplied
9311 Request issue date must be supplied, and must be prior to, or the same as, the date of the medical service and cannot be before the date of birth
9312 Claimant first name, family name, date of birth, claimant Medicare card number and reference number must be supplied. If any one data element is supplied, then all five (5) must be supplied.
9313 Patient/Claimant address line 1 must be supplied or all claimant address elements removed.
9314 Patient/Claimant locality must be supplied or all claimant address elements removed
9315 Patient/Claimant postcode must be supplied or all claimant address elements removed
9316 The Referring/Requesting Provider cannot be the Servicing or Principal Provider
9317 Account payment status required. Must be paid or unpaid.
9318 Non standard referral has been set without the referral period
9319 Date of lodgement not supplied
9320 Time of lodgement not supplied
9321 Location ID not supplied
9322 Referral period details must be supplied
9323 Incomplete banking details. BSB code, account number and account name must all be supplied.
9324 Claim ID not supplied or invalid
9325 Service type not supplied
9326 At least one voucher must be included in the claim
9327 Claim type must be consistent with the transmission type set by the createTransmission function
9328 The maximum number of contents allowable in this transmission has been reached
9329 The data element being set is not relevant to this claim type
9330 The data appears to be other than a stored patient claim
9331 The data appears to be other than a stored bulk bill claim.
9332 Voucher must contain at least one (1) service
9333 Assignment/submission authorisation not supplied
9335 Bank account details supplied for unpaid claim
9336 Hospital details must be supplied in the text field
9337 At least one service in the voucher must have a non zero charge amount
9338 A required charge amount has not been supplied or is inconsistent with other data supplied.
9339 Transmission date missing or invalid
9340 Transmission time missing or invalid
9341 More information required. Either text must be keyed against a service or a time supplied for the voucher.
9342 The Payee Practitioner supplied is the same as the Servicing Provider. If both are the same, only one of the Servicing Provider should be completed
9343 Veterans File Number/patient details incomplete
9345 Patient’s Date of Birth not supplied
9346 Patient’s gender not supplied
9347 Request type code must be set when a request exists
9348 Batch Identifier missing or invalid
9349 Immunisation Date invalid or missing
9350 Next Due Date for immunisation invalid or missing
9351 Medicare Card Issue Number missing or invalid
9352 Provider Child ID missing or invalid
9353 Information Provider Number missing or invalid
9354 ATSI Indicator missing
9355 Contact phone number missing or invalid
9356 Vaccine code missing or invalid
9357 Vaccine dose missing or invalid
9358 Clinic Code missing or invalid
9359 Vaccine Batch Number missing or invalid
9360 HepB Birth Dose Flag invalid or missing
9361 Encounter details do not contain an allowable combination of the minimum required fields
9362 The encounter must contain at least one (1) episode
9363 Encounter already contains equivalent antigen(s)
9364 Patient information provided is insufficient
9365 Referral period or referral date to must be supplied
9366 Referral Date From must be supplied
9367 Referral Date From is later than Referral Date To
9368 Hep B Birth Dose Date is prior to Patient’s Birth Date or prior to 1 January
9369 The patient Fund membership number must be supplied
9370 The Fund brand Id must be supplied
9371 OPV type must be supplied
9372 The claim type for the claim must be supplied
9373 Discharge date supplied therefore admission date must also be supplied
9374 Both product name and version must be supplied
9375 All vouchers within the claim must have the same service type code
9376 Facility Id or Treatment Location Provider Number must be supplied
9378 Claim Type has been identified as an Agreement, the Facility Identifier must also be supplied
9379 Claim Type has been identified as an Agreement, Informed Financial Consent must also have been identified as being verbally given or supplied in writing for the patient or indicated as not obtained
9380 Claim Type has been identified as a Gap Cover scheme, Informed Financial Consent must also be identified as being supplied in writing for the patient or indicated as not obtained
9381 Claim Type has been identified as a Gap Cover Scheme, Financial Interest Disclosure must have been given
9382 Conflicting selection criteria supplied. When TransactionId supplied no other criteria can be supplied.
9383 If either ReceivedFromDateTime or ReceivedToDateTime set both must be set
9384 ReceivedFromDateTime must be prior or equal to ReceivedToDateTime
9385 RequestContentType must be supplied
9386 Maximum request period cannot exceed 31 days
9387 Request must specify either one or more transaction Ids or a received date time range
9388 Request must specify one or more Transaction Ids
9389 The account reference Id must be supplied
9390 The Billing Agent Id must be supplied
9391 Payer name, payment run date, payment reference, deposit amount, payee Location Id, part number and part total must be supplied
9392 Benefit amount, Date of lodgement and Account Reference Id must be supplied for each claim
9393 The Transaction Id must be supplied for each claim where the claim channel code is SB3 or SB4
9394 The number of items exceeds the maximum allowable for this content type
9395 Fund claim explanation code must be supplied as the claim has been rejected by the Fund
9396 Incomplete data in outbound transmission
9397 Principal Provider Number must be supplied
9398 OEC type must be supplied
9399 Accident indicator must be supplied
9400 Length of stay must be supplied and cannot exceed the number of days from the date of admission to date of discharge inclusive.
9401 Presenting Illness Code must be supplied.
9402 Same day indicator / code must be supplied.
9403 Admission date must be supplied
9404 Date of admission and date of discharge must be consistent for all vouchers
9405 FundReferenceId must be supplied
9406 Table name, description and scale must be supplied
9407 The financial status of the member must be supplied
9408 Benefit must be supplied for each service
9409 Fund explanation code and explanation text must be supplied
9410 If service explanation code or service explanation text is supplied both must be supplied
9411 The compensation claim indicator must be consistent across all vouchers within the claim
9412 Collection date time and accession date time must be supplied for all services in the voucher where S4B3 exemption is indicated against any service in the voucher
9413 Collection date time must be prior to accession. Date of service must be on or after the date of accession. Collection date must be on or after date of birth and the date of the request.
9414 If collection date time or accession date time is present both must be present
9415 Date of service cannot be prior to the accident date
9416 The service must have been rendered in hospital where S4B3 exemption is indicated against the service
9417 Service must have been requested, self deemed or a request override set
9418 Payee Provider Number must be supplied
9419 Both the concomitant provider number and role must be set. The concomitant provider can only undertake a single role and cannot be the servicing provider.
9420 The Servicing provider must be the same for all vouchers within the claim
9421 Benefit assignment authorisation details must be supplied or are incomplete
9422 Clinical condition information missing or incomplete
9423 Clinical indicators, request/referral details and/or results and related information is missing or incomplete
9424 Health Care Plan details (type, issue date) incomplete
9425 Dates of service within the voucher must be consistent
9426 Check KMs. Only one km entry permitted per voucher and the voucher must contain another item with the same Date of Service.
9427 Service start date must be on or after the patient’s date of birth and on or before the date of service and service end date.
9428 The service end date must be on or after the date of service and the service start date and supplied where number of services is greater than one.
9429 When duplicate service override requested or supporting details supplied both must be present
9430 When multiple procedure override requested or supporting details supplied both must be present
9431 The original procedure date must be on or after the patient’s date of birth and on or before the date of service
9432 Item start date-time must be supplied. It must be on or after the patient’s date of birth and the Date of Service, and prior to the Item End Date Time.
9433 Item end date-time must be supplied. It must be on or after the date of service and after Item Start Date Time
9434 Time in future. The date and time supplied must not be in the future.
9435 Time of service must be set against all items within the voucher if set against any item within the voucher, except where DistanceKms is set
9436 Anaesthetic type code must be supplied
9437 When AfterCareOverrideInd or AfterCareExplanationText present both must be present. Both may be present when AfterCareApportionedPercentage or AfterCareProviderNum present
9438 Aftercare provider number required and must not be the same as the servicing provider.
9439 Either the service has been flagged as having been self deemed or the reason for the service being self deemed has been supplied. If one is present both must be present.
9440 The appliance order date must be greater than or equal to the patient’s date of birth and equal to or less than the date of service and delivery date. Supporting details must be supplied where an appliance has been ordered.
9441 When intensive care override requested or supporting details supplied both must be present
9442 A service cannot be substituted without request details also being present
9443 Original procedure details (date, item number and supporting details) are missing or incomplete
9444 Anatomical details (region and description) are missing or incomplete
9445 Where item is set to KM or the distance travelled is stated, both must be present without a charge amount
9446 Fund Payee Id must be consistent across all vouchers.
9447 A Segment Identifier is missing or invalid
9448 A TFR segment must be supplied
9449 ACS segment must be supplied and can only be supplied, if any of ACD, CCG or LPD segments are also supplied
9450 Leave period must be supplied when the leave days indicated in the Accommodation Summary is greater than 0
9451 A PSG segment must be supplied
9452 An MSG segment must be supplied
9453 A DMG or PSG segment must be supplied
9454 A DMG segment must be supplied
9455 A MED segment must be supplied
9456 Urgency code must be supplied
9457 Compensation code must be supplied
9458 Contiguous claim code must be supplied
9459 Facility Type Code must be supplied
9460 Transaction Id of claim to be adjusted must be supplied.
9461 Patients’ Medical record number must be supplied
9462 Patient Admission Weight can only be set if the patient is less than 365 days old.
9463 Accommodation status must be supplied
9464 Facility Contract Status Code must be supplied.
9465 Episode Id must be supplied
9466 Episode Type Code must be supplied
9467 Patient Classification Code must be supplied
9468 Referral Source Code must be supplied
9469 Charge Raised Code must be supplied
9470 Service Code must be supplied
9471 Service Code Type Code must be supplied
9472 From Date is either missing or after To Date
9473 ANB segments must contain Baby Date of Birth, Family Name, First Name, Gender and Number.
9474 Transfer Code must be supplied
9475 Accommodation Day must be supplied
9476 To Date must be supplied
9477 Number Of Days must be supplied
9478 Leave Days must be supplied
9479 An ACD Segment must contain Bed Level Add On Indicator and Bed Level Code
9480 Day Rate must be supplied
9482 A CCG segment must contain a Critical Care Type Code and Critical Care Add On Indicator must be set.
9483 Service Time must be set for all PSG segments with the same Date of Service.
9484 A TRG segment must contain Distance Kms, Transport Hours Minutes, From Locality, To Locality, Start Time and Transport TypeCode.
9485 An MIG segment must contain both a Service Quantity and Service Rate.
9486 Principal Diagnosis must be supplied
9487 Ventilation Hours Minutes must be supplied
9488 Only 49 secondary diagnosis and 50 procedures can be set within a DMG segment.
9489 Casemix Code Type Code must be supplied
9490 Issue Date must be supplied
9491 Certificate Type Code must be supplied
9492 Text must be supplied
9493 Either CertifyingProviderNum or CertifyingProviderName must be supplied
9494 Admission time must be supplied.
9495 Previous Transaction Id and Previous Account Reference cannot be set when Claim Channel Code is SB3 or SB4.
9496 Benefit Amount cannot be negative when Claim Channel Code is SB3 or SB4.
9497 Either Presenting Illness Item Number or Presenting Illness Code must be set, but not both.
9498 Cannot submit fully paid accounts for this claim type.
9499 Service Quantity must be supplied.
9500 Patient Admission Weight must be set if the patient is less than 365 days old
9501 A submission response report is available
9502 Multiple reports are included in the response
9503 More reports meeting the criteria are available for retrieval
9504 More rows for this report are available for retrieval
9601 The claim needs to be referred to a Medicare Customer Services Officer for further assessment. The claim will be processed and payment notification will be sent in the near future.
9602 This claim cannot be lodged through Medicare Easyclaim. Please submit the claim via an alternative Medicare claiming channel.
9603 Check location. The location entered for the address is invalid.
9604 Check bank account name. The name supplied is not a valid account name.
9605 Another Medicare Card may have been issued to the patient or the details you entered do not match those held by Medicare. Please update your records and resubmit the claim.
9606 Another Medicare Card may have been issued to the claimant or the details you entered do not match those held by Medicare. Please update your records and resubmit the claim.
9607 This item is only claimable via Bulk Bill
9608 The service requires confirmation that an operative procedure from groups 03 -09 has been performed subsequent to the attendance.
9609 Time (duration) required for the item
9610 Equipment number required
9611 Check item. The item claimed is either unknown or invalid at the date of service. Eg Misc, incorrect alpha included
9612 This service is normally only performed in a hospital
9613 This service cannot be performed in hospital
9614 Check bank account number
9615 An error has been detected with the address
9616 The BSB supplied is invalid, unknown or cannot be used for Medicare payments
9617 The referral has expired
9618 Either an amount has not been entered in the charge field or an invalid amount has been entered.
9619 Check postcode and locality. This is not a recognised combination OR a PO Box type locality has been entered.
9620 The radiotherapy service performed is not payable using the equipment number
9621 The pathology, diagnostic imaging or specialist service cannot be self determined or the Practitioner cannot self deem
9622 The attendance item must contain the number of patients seen
9623 Payee Provider cannot be used with an assistant surgeon item ( 513000 or 51303 ) or an assistance anaesthetist item ( 17500 )
9624 A subsequent consultation has been keyed and the date of service is after the referral expiry date
9625 Claimant address needs to be updated with Medicare, Issue account/receipt for the claimant to submit via an alternative Medicare claiming channel.
9626 The patient is or was covered under the Reciprocal Health Care Agreement
9627 Check date of service
9628 Referral or request required
9629 Check item and patient
9630 Please check the request or referral details
9631 Check if service self deemed
9632 Duplicate of service already paid. If not duplicate resubmit with appropriate indication.
9633 A new Medicare card has been issued. Please update your records and ask the patient to use the new card number for any future claims.
9634 A new Medicare card has been issued. Please update your records and ask the claimant to use the new card number for any future claims.
9635 Check Servicing Provider. May not be able to provide the service for this item at date of service
9636 Check Payee Provider
9637 More information is required. Service text or other information is required to support this service.
9638 Claimant details required. Patient or quoted claimant is a minor.
9639 PO Boxes are not an acceptable address type for this claiming method.
9640 The benefit assessed for this claim exceeds the review threshold. While no assessing errors have been detected, the claim needs to be reviewed by a Medicare operator.
9641 A restrictive condition exists
9642 DVA Pathology not supported in this release.
9643 Check claimant name
9644 Mix of in hospital and out of hospital services are not permitted
9645 The claim identified for deletion has a status other than Paid Same Day
9646 The claim could not be located by Medicare.
9647 The claim has already been deleted by Medicare.
9648 The Reason Code for requesting Same Day Delete is missing or invalid
9649 Patient’s eligibility cannot be determined
9650 The patient data supplied failed validation checks against Medicare data.
9651 The transmission Id supplied is not valid
9652 Enter either all address details or no address details for the claimant
9653 Multiple claims have been identified at the Medicare Central Site matching this deletion request. Please contact the Medicare eBusiness Service Centre to delete the correct claim.
9654 Mixed LSPNs within a voucher are not allowed
9655 An LSPN is required
9656 An LSPN is invalid
9657 LSPN not recognised
9658 LSPN not valid at date of service
9659 SCP Invalid
9660 This item cannot be used as a substituted service
9661 This provider cannot substitute services
9662 Provider must contact Fund
9663 Check Fund and Membership Card details
9664 Check Patient details. If correct, check Fund and Membership Card. If correct, the name known to the Fund may differ from that held by Medicare OR Patient Unique Identifier has not been supplied (if applicable to Fund).
9665 Cannot uniquely identify Patient from information supplied
9666 Patient must contact Fund
9667 Health Fund Membership cover suspended or cancelled
9668 Medical claims are not covered for this patient. Patient must contact Fund
9669 Membership details matched however claims for the patient cannot be submitted using this channel at this time. Patient to contact Fund
9670 Claim type identified cannot be submitted through this channel at this time. Please submit claim through another channel.
9671 The Health Fund identified does not currently accept transmissions through this channel
9672 Your Fund information is out of date. Please update your Fund list and resubmit.
9673 Fund registration record is incomplete or needs correction. Please contact the Medicare eBusiness Service Centre for assistance.
9674 Fund patient validation not undertaken as the Medicare validation was unsuccessful
9675 Current Medicare card has expired. Patient must contact Medicare as claims using this Medicare card may be rejected.
9676 The equipment required for this service is not registered for the LSPN provided
9677 The equipment used for this service has exceeded the required equipment age
9678 The service is not payable as an appropriate associated service is not present
9679 The content type specified does not match the actual type of the specified Transaction Id
9680 Claim assessment code is invalid for this claim
9681 Item only payable if the Servicing Provider is in RRMA 3 – 7, Tasmania or in an eligible SSD
9682 Medicare cannot assess the request due to a system limitation. Please contact the ebusiness service centre to discuss.
9683 Medicare cannot assess this request due to a system limitation. Please check patient details and then contact the Medicare eBusiness Service Centre should assistance be required.
9684 The unique patient identifier supplied was not valid for this membership. Check the patients fund membership card for the correct patient identifier.
9685 A concessional entitlement has not been found for this patient
9686 Baby not known at Fund.
9687 EFT details are not registered at this fund for this provider or Facility. Fund must be contacted before further claims are submitted.
9688 An Admission / Discharge Date can only be supplied for services flagged as being performed in a Hospital.
9689 Services relating to the specified Service Type Code can only be submitted for a single patient per claim / request.
9690 Only Medicare can handle MBS items and Medicare can only handle MBS items.
9692 An Item Number must be supplied for every MBS service.
9694 The referral period type must be identified.
9695 Fund does not perform OEC with prosthetics or miscellaneous items at this time.
9696 For IMC, set both ClaimId and ClaimChannelCde. For IHC or OVS, set neither.
9698 Service is possible aftercare, check the account and resubmit with a valid indicator if not normal aftercare
9699 Item not covered for this patient at this date of service
9700 An incorrect item number appears to have been used/amount claimed does not match item number
9701 The maximum number of services for this item have been paid, if this service is not a duplicate please resend with correct item numbers as per MBS
9702 A base item has not been entered or should be entered first. Please re-submit claim with correct sequence.
9703 Item number used can not be claimed for this Provider. Check details of service and re-submit with appropriate item.
9704 This service appears to have been previously claimed. Please contact Medicare if you wish to discuss.
9705 In some instances where two or more services are performed together, they are claimable under one item number. Please check the MBS for correct item and resubmit. If exceptional circumstances exist, please issue account/receipt notating reasons.
9706 This item requires a specific notation of the relevant condition. Please check the MBS and resubmit via an alternative Medicare claiming channel.
9707 This claim needs to be referred to a Medicare Customer Services Officer for further assessment. Please issue claimant with an account/receipt to claim via an alternative Medicare claiming channel.
9708 Equipment number entered does not appear to be registered with Medicare, correct details and re-submit or contact Medicare.
9709 An age restriction applies to this item. Please check the MBS to verify item specifics.
9710 This item number has specific restrictions. Please refer to the MBS and ensure you are entering the correct patient details.
9711 This claim requires further assessment by a Medicare Customer Services Officer. Please issue claimant with an account/receipt to claim via an alternative Medicare claiming channel.
9712 The item number claimed and an override code used cannot be used together. Please resubmit the claim or contact Medicare for assistance.
9723 ToothNum is an invalid value
9725 UpperLowerJaw is an invalid value
9728 NumberOfTeeth is an invalid value
9742 SecondDeviceIdentifier is an invalid value
9743 SecondDeviceIdentifier is missing
9744 OpticalScript is an invalid value
9745 OpticalScript is missing
9754 ReferralPeriodTypeCde is inconsistent with the ServiceTypeCde and or/other data elements set
9755 AdmisssionDate must be greater than or equal to the PatientDateOfBirth
9756 DischargeDate must be greater than or equal to the AdmissionDate
9757 AdmissionDate not set
9759 TimeDuration is missing
9761 TimeDuration is an invalid value
9762 AdmissionDate must be a valid date
9763 DischargeDate must be a valid date
9764 DischargeDate must be greater than or equal to the PatientDateOfBirth
9765 Site Not Accredited for this service
9766 TimeOfService must be set if either DuplicateServiceOverrideInd and / or MultipleProcedureOverrideInd and / or Rule3ExemptInd are set to Y.
9768 Authorisation date is invalid or missing
9767 Claim Certified date is an invalid value (this may apply where Authorisation date explicitly set)
9769 VoucherId is missing
9770 PatientSecondInitial is an invalid value
9771 ChargeAmount cannot be set where ServiceTypeCde = F
9772 ReferralOverrideTypeCde cannot be present where ServiceTypeCde is set to F or K
9773 ChargeAmount cannot be claimed for item number OT80
9775 Invalid Transaction Id
9776 Maximum number of Transactions cannot exceed 500
9777 Duplicate Transaction Id
9778 ReferringProviderNum and ReferralIssueDate must both be set when ServiceTypeCde is set to F ( Community Nursing ) or K ( Clinical Psych )
9999 An indeterminate error has been detected