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Get NY EMEDNY-432301 2010

enter a Service Authorization (SA) Exception Code of “7” on the claim. On the paper claim form (eMedNY 150001), this is entered in Field 25D. Electronically, the SA Exception Code is submitted in the SA Exception Code Segment of Loop 2300 for the 837 Professional claim format. ePACES users will find the SA Exception Code field in the Professional Claim Information Tab – toward the bottom. PROVIDERS SHOULD ENTER THEIR USUAL AMOUNT CHARGED, WITHOUT INCLUDING THE 30 PERCENT ADD-ON. eMedNY WI.

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