Will the submission of duplicate diagnosis codes in the same EDR generate EDFES edit 255 - Diagnosis Code?


For Institutional records, Encounter Data Front End System (EDFES) edit 255 will not generate a rejection when the Principal Diagnosis code (qualifier ABK or BK) is duplicated in an Other Diagnosis code (qualifier ABF or BF) on the record. For Professional records, if the Principal Diagnosis code is duplicated on an Other Diagnosis code field, edit 255 does apply and will result in a rejection. When diagnosis codes are duplicated within the Other Diagnosis (ABF or BF) fields within a record, edit 255 does apply to both Institutional and Professional records.

Source: User Group Q&A Documentation from January 19, 2017

Last Updated: 01/19/2017