Claims Submitted With Dental Codes As Principal Diagnosis Will Reject

On 1/3/2021, EDI added a new edit to the EDI Front-End. If an 837I claim contains principal diagnosis code 2300 HI with qualifier ABK (principal diagnosis) that is a dental service, the claim will be rejected in the EDI Front-End. The rejection will be displayed on the 277CA (277 Claims Acknowledgement) with the following codes:

CSCC: A7 “acknowledgement/rejected for invalid information”
CSC: 254 “Principal Diagnosis Code”

Dental Diagnosis Code List:

Dental Diagnosis Code List

This change benefits our providers so that claims can be resubmitted as soon as they are corrected. There is no waiting for the claim to process and therefore no need to request an appeal, or submit an adjustment. The 277CA rejection can also be used to report the rejection to secondary insurance.

Helpful Resources

EDI Front End Rejection Code Lookup Tool
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