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Description:

  1. Errors in this edit are generated only under the following conditions:
    1. We know patient gender, and
    2. The CPT code has Gender Indicator.
  2. The errors are generated if Patient Gender <> Gender Indicator of the CPT code.

Edit ID: 10005

Error type: ERROR

Error message example 1:

This example is provided for the following scenario:

  1. CPT code = 00952.
  2. Patient Gender = Male.

CPT code 00952 may not be used for a male patient.

DESCRIPTION

CPT code 00952 = Anesthesia For Vaginal Procedures (Including Biopsy Of Labia, Vagina, Cervix Or Endometrium); Hysteroscopy And/Or Hysterosalpingography

Error message example 2:

This example is provided for the following scenarios:

  1. CPT code = 52442.
  2. Patient Gender = Female.

CPT code 52442 may not be used for a female patient.

DESCRIPTION

CPT code 52442 = Cystourethroscopy, With Insertion Of Permanent Adjustable Transprostatic Implant; Each Additional Permanent Adjustable Transprostatic Implant (List Separately In Addition To Code For Primary Procedure)

Owner object: Activity

Owner object property name: Code

Owner object property value: Value of Activity.Code

Reference object: Claim

Reference object property name: ID

Reference object property value: Value of Claim.ID


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