Reopening requests - common errors

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Home ► SPOT instructions ► Reopening requests - common errors

Last Modified: 5/28/2023 Location: FL, PR, USVI Business: Part B

Reopening request – common errors

There are times it will appear as if SPOT is not allowing you to edit a field (e.g., modifier, DOS). When you try to add a value, delete a value, or edit a value, SPOT will not display the new information. This perceived common error is the result of SPOT’s validation process.

When you select a request type that requires the editing of one or more fields (i.e., Edit DOS From, Edit DOS To, Edit DOS Both, Edit Modifier, Edit Diagnosis Code, or Edit Procedure Code), SPOT will validate the new/replacement value as soon as the cursor leaves the edited field based upon specific criteria.

SPOT will validate the new/replacement value as soon as the cursor leaves the edited field based upon the following criteria:

• Formatting -- each field has a specific set of formatting guidelines. To view the formatting guideline for a specific field, place your cursor over the

next to the corresponding column.

• Authenticity -- the value entered must be an authentic diagnosis code, modifier, or procedure code (as applicable). For example, a value of 000.1 is not a real diagnosis code and would not be accepted as a replacement code by the SPOT.

• Acceptability -- the value entered must be one that is permissible to use in a claim reopening through the SPOT. For example, the WU modifier may not be used as a replacement code for a claim reopening.

• Logic -- the relationship between the DOS From and DOS To values must be a logical relationship. For example, the DOS From value cannot be later than the DOS To value.

Since SPOT validates an edited field after the cursor has moved out of the field, SPOT will reject the new/replacement value and revert to the field’s original value if any of the following conditions occur:

• User tried to copy and paste a new/replacement value in the edit field

• User moved the cursor out of the editable field before typing in a new/replacement value

• User entered an invalid value

• User did not enter a new/replacement value in all required fields (applicable to Edit DOS Both request type)

• User entered a new/replacement value that may not be utilized in a claim reopening request

• User entered a new/replacement value that does not meet conditional requirements (e.g., entering a DOS From value that is later than the DOS To value)

• User entered a new/replacement value that does not meet formatting requirements (e.g., entering DOS From value as m/d/yy instead of mm/dd/yyyy)

Request type example: Edit DOS

Once you have accessed the claim you wish to correct, follow these steps:

1. Select the line item you wish to correct

For this example, select Line Item 01

2. Select the Request Type based upon the field you wish to edit for that line item.

For this example, select Edit Both DOS for Line item 01

3. Once you have selected the request type for the line item, the editable field(s) will have a white background

4. Use your cursor to highlight the original value

5. Use the delete key to remove the original value, but do not move your cursor from the field

If you move the cursor out of the field before you type in the replacement value, the SPOT will display an error message, and the value will remain unchanged.

6. Type the new/replacement value into the field (do not use copy and paste to enter the value)

In this example, the new/replacement dates of service for Line 01 is 03/20/2018. If you try to copy and paste the new value into the editable field or if you accidentally move the cursor out of the field before you type in the new value, the SPOT will display an error message, and the value will revert to the original value

7. Once the new/replacement value has been typed into the editable field, you may use the Tab key or move the cursor out of the field.

8. If the new/replacement value meets all of the SPOT’s validity criteria, you will be able to edit another line item or click the Review button.

For more information on claim reopening requests, please refer to The SPOT: User Guide pdf file

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