New claim edit: Invalid place of service code

Stedi now rejects 837P professional and 837D dental claims that contain invalid place of service codes.

How the edit works

Place of service codes are two-digit codes that indicate where a service was delivered. The Centers for Medicare and Medicaid Services (CMS) maintains a list of valid place of service codes. For example: 11 (Office) or 23 (Emergency Room – Hospital).

If a professional or dental claim includes an invalid place of service code, the payer may reject the claim. This can delay payment for the provider.

This edit – the industry term for an automated validation rule – catches the issue before the claim reaches the payer.

Rejection errors

If you submit a claim that fails the edit using Stedi’s Claim Submission API endpoints, you’ll get back an error response in real time. The response includes details in the errors array:

{
  "errors": [
    {
      "code": "33",
      "description": "Invalid Place of Service code. The submitted place of service code, A5, is invalid. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit a claim that fails the edit using SFTP, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will include a related claim status category code, claim status code, and error message:

STC*A7:N249*[DATE]**[AMOUNT]********Invalid Place of Service code. The submitted place of service code, [Place of Service Code], is not a valid two-digit number or unassigned. Correct and resubmit