Common DHS Reviewer Exception Codes

MMIS posts DHS reviewer exception codes (EC) on Type B Service Agreements that require DHS to review and finalize the agreements. DHS reviewer exception codes have a status of 3 (deny) or 4 (suspend). Lead agency staff cannot be resolve DHS reviewer exception codes.

In most instances, MMIS automatically routes service agreements to DHS when MMIS posts one or more DHS reviewer exception codes.

Exception codes 241, 412 and 420 only route a Type B SA for PCA to DHS for review and finalization when posted on lines with DHS provider A342517700 entered in PROV NBR field. This is usually when a recipient has not chosen a PCA provider.

140 HEADER/LINE ITEM STATUS SUSPEN posts when one or more line items are suspended and one or more of the following reviewer exception codes post. Do not resolve.

233 HOSPICE RECIP INELIG FOR SVC posts when recipient has elected the hospice benefit.

241 PROVIDER TYPE/SERVICE CONFLICT posts when provider not authorized to provide this service.

412 CATEGORY OF SERVICE IS MISSING posts when the category of service code is ended or missing from the provider file.

420 PROVIDER ENROLLED AS NO-PAY posts when the provider’s enrollment status is equal to active-no pay (provider not authorized to provide services).

442 SVC NOT ALLOWED DUE TO MRRP posts when recipient is on Minnesota Restricted Recipient Program (MRRP) restrictions or does not qualify for a program.

861 HOME CARE RATING MISSING/INV posts when Service Agreement date span is 45 days or less.

888 LINE NEEDS DHS REVIEW posts when services overlap and MMIS posts other DHS reviewer exception codes.

893 SERVICE AGREEMENT ENTERED LATE posts when the entry date (Julian date) of the document is after the start date of the SA. Check your date(s) and correct if needed.

894 START/ENTER DATE CONFLICT WITH ASSESSMENT posts when the SA start date or entry date (Julian date) is prior to the assessment date and not resolved.

895 AMOUNT TOO LARGE FOR SYSTEM posts when PCA supervision (T1019 UA) is over the allowed cap.

897 SEPARATE PCA OUT MONTHLY WHEN ON MRRP posts when recipient on MRRP and PCA services were not broken out by months. To resolve, enter one month of PCA service (T1019). .