Common Error Codes

Here are some common error codes and steps you can take to fix the error.

• Wellmark Claims – Date of Service Not in Policy Dates for Insured ID
• External Code Does Not Exist/Ineffective Date Range
• CodeSetErr: SvcDate Not in ICD-9
• EMC Provider Not Authorized for Transmission

Wellmark Claims – Date of Service Not in Policy Dates for Insured ID

Problem
INet Transaction (TXN) report states the following error: Wellmark claims where Date-of-Service not in policy dates for insured ID.

Solution
This error is caused if one or more dates in the claim is not within the policy effective date of the subscribers coverage, or the patients date of birth is different than the date of birth on the policy. It is advised to double check the dates within the claim and resubmit upon correction.

External Code Does Not Exist/Ineffective Date Range

Problem
INet Transaction (TXN) report states the following error: External Code does not exist or is in an ineffective date range.

Solution
This error is caused by using one or more invalid HCPCS or Diagnosis codes on the claim. The error can also happen if the HCPCS or Diagnosis Code used has expired. Verify that the HCPCS or Diagnosis codes used are valid and have not expired. If an invalid or expired code is used, claims will need to be corrected and resubmitted.

CodeSetErr: SvcDate Not in ICD-9

Problem
INet Transaction (TXN) report states the following error: CodeSetErr: SvcDate not in ICD-9 "the code" effective range MM/DD/CCYY - MM/DD/CCYY.

Solution
This is an update to the error message on the TXN when an invalid Diagnosis or HCPC code is used. The error now includes the invalid Diagnosis or HCPCS code used and when the code expired.

EMC Provider Not Authorized for Transmission

Problem
INet Rejection report states the following error: EMC Provider Not Authorized for Transmission.

Solution
This error is caused by one of two reasons:

• The provider number submitted in the claim is not currently setup to send claims electronically. Contact EC Solutions Assistance Center to verify that the provider number is setup.
  
  
• The billing provider number submitted is an individual/rendering provider number and not the group provider number. If the individual/rendering provider is attached to a group, the group number will need to be submitted as the billing provider number. Claims will need to be correct and resubmitted.

Further support is available by calling EC Solutions Assistance Center at 1-800-407-0267, Monday through Friday 7:00am to 5:30pm. Please leave a voicemail after normal working hours and your call will be returned the next business day.

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