Priority Health - Clinical Edit Error Fixed for Hospital Care, Discharge Services:

March 13, 2023

We recently fixed an error with a clinical edit impacting the following services: 


  • Initial hospital care services (99221-99223) 
  • Follow-up hospital care services (99231-99233) 
  • Hospital discharge services (99238-99239) 


The edit was incorrectly denying these services between Jan. 1, 2023, to Jan. 31, 2023, when billed with place of service codes 19, 22, 23 and 24.  


There’s no need to resubmit or appeal impacted claims. We’re automatically reprocessing them.


If you’ve been holding onto claims for these services, you can submit them now.