Errors and Warnings in the VSP Interface

While submitting VSP orders and claims through the new interface, you may encounter two types of messages for on-hold claims:

Errors
Warnings

This section explains the difference between those types of messages.

For a list of all the VSP error and warning messages, including explanations and examples, see List of VSP Warnings and Errors.

Errors

Errors are identified by the word Error. Errors reflect conditions that must be corrected before the order or claim can be submitted. If you don’t correct the error, the message reappears when you try to resubmit the order or claim.

Warnings

Warnings are distinguished by the word Warning. For warnings, you can do either of the following:

Fix the order or claim.
Acknowledge the issue and continue with the order or claim as it is.

For information on how to acknowledge a warning and submit the claim without making any changes to the order or claim, see Acknowledging Warnings in Claims Management.

Acknowledging Warnings in Claims Management

Ideally, you should fix all problems with a claim before submitting it. However, if a claim is on hold due to warnings, you can simply acknowledge them and take the claim off hold so it can be submitted.

Open the Claim Detail window for the claim, and check to see if it has warnings:
- If the claim is on hold because of a warning, the new Warnings button appears.
- In the Claim Note window for claims placed on hold, warnings are indicated by the word Warning in the Note field.
Click the Warnings button.
The Warnings window opens.
In the Ack column, select the check boxes of the warnings that you want to acknowledge but not resolve, and then click Save.

If you acknowledge warnings, the Warnings button in the Claim Detail window remains visible. If you resolve all the warnings, the Warnings button disappears.

Click Ready to Bill Carrier.
The next time the billing integration runs, the claim is billed.

List of VSP Warnings and Errors

The tables in this section list all the warnings and errors you might encounter in the VSP interface and point you toward a resolution. The resolution differs based on if a warning or error. To continue processing a VSP claim:

VSP Warnings — You either fix the error specified in the warning or acknowledge the error and submit without fixing it.
VSP Errors — You must fix all VSP errors before you can submit.

For more information, see Using the New VSP Interface for AcuityLogic .

Automatic VSP benefit calculations are not currently available for IOF lenses. When pricing a VSP IOF lenses order, calculate the amounts manually.

If you see error ADJUDI0031, it may be related to the IOF lenses. If the order includes IOF lenses, override and calculate the amounts manually.

VSP Warnings

The following table provides information about all the warnings you might see in the VSP interface:

Warning ID	Warning Text	Generic Processor Message	Explanation	Examples
Frequent Errors and Warnings
ADJINV0001	Service code is invalid	—	The service code is not valid for the specified product.	For this error, you need to edit the claim. For example, CPT 92250 is billed on a signature benefit with exam and refraction. Modifier 52 is not on 92250.
ADJINV0002	Service code is not valid for the date of service	—	On the date of service (DOS), the billed code is not active.	For this error, you need to edit the claim. For example, bill code 92275 after a 01/01/2020 DOS.
ADJINV0005	Service code and modifier combination is not allowed or missing	—	This error can occur when the specified service code/modifier combination is not allowed or when the service code requires a modifier that is not available.	For example, billing CPT code 92250 without modifier 52 would trigger this error. You need to edit the order to include the correct service code/modifier.
ADJPRD0002	Services billed are not payable under this benefit	—	When a service is not listed as a covered benefit in the client's product catalog, this warning appears.	This can occur when an authorization is for PEC/DEP+ but the bill is for materials or when the product package is "additional pair" but the bill is for an exam.
ADJPRD0009	Service not covered	Service not covered due to another service billed or missing.	When a service is not covered because of an include/exclude rule, this error appears.	For this error, you need to edit the claim.
ADJUDI0001	Dependent service is not payable	—	This occurs when two related services must be paid together but cannot because the primary service is not on the claim or is not payable for some reason other than eligibility.	This can occur in numerous situations such as the following, depending on the presence of other factors such as the claim's product package: - A contact service is not payable because the contact lens materials were not billed (the product package requires both). - A frame case is not payable because the frame is not payable. - Lens enhancements are not payable because the base lens is not payable. - Refraction is not payable because the exam is not payable. - (Elements with Non-Otis & Piper frames) Frame and lens are denied without the KX modifier. - Vision Savings Pass requires lens and frame. If either is missing, the other triggers this warning.
ADJUDI0021	Frame billed amount exceeds frame wholesale allowance	—	The wholesale cost of a frame is greater than the wholesale allowance on a patient's coverage. This is not the retail amount billed to the patient.	This occurs when you create your own frame. Recommended action is to reduce the wholesale cost on the frame.
ADJUDI0030	Service is included in the exam service payable on the claim	—	Refraction is not separately payable because it is covered by the exam code.	For example, this warning appears if S0620 (exam including refraction) is billed with 92015 (refraction). You can acknowledge this warning.
ELIGIB0004	Authorization has an invalid status	—	The status should be Issued, Authorized, or Duplicate.	The authorization might already have been sent to a lab, paid, denied, or deleted.
ELIGIB0012	Member policy not found for client, division, and subscriber consumer id	—	This is unlikely to occur when an authorization exists. It is typically caused by a change in data on the VSP side. If you receive this warning, contact VSP.	Confirm the patient is covered for the date of service and then contact VSP to get an authorization.
ELIGIB0021	The patient name on the VSP Coordination of Benefits Secondary Authorization number you have entered does not match the patient name on the primary claim	—	The patient name must be the same for the patient on the first and second authorizations.	Acknowledge the warning and put the primary claim back in ready to bill.
OFFEXP0001	Please indicate whether or not refraction has been performed	—	If a 92*** exam code is billed without a 92015 refraction code, this warning appears. S0620 and S0621 include refraction, so this warning does not apply to them.	Acknowledge the warning.
OFFEXP0014	You have requested a Horizontal Prism in only one eye. Do you want to continue?	—	In the Rx information, only the right or left eye has a horizontal prism value. That's rare, so we provide a warning.	Acknowledge the warning.
OFFEXP0015	You have requested a Vertical Prism in only one eye. Do you want to continue?	—	In the Rx information, only the right or left eye has a vertical prism value. That's rare, so we provide a warning.	Acknowledge the warning.
OFFEXP0016	Important! Frame only claims will be denied if they do not meet VSP's criteria. Please refer to the 'Providing Frames' section of the eManuals for more info	—	This warning appears in any frame-only claim. Because frames on their own are not typically covered, this alerts the user to check to ensure the patient has frame-only benefits. If the patient does not, the claim will be denied.	Acknowledge the warning.
OFFEXP0022	This claim has passed VSP's diagnostic criteria for necessary contact lenses. No additional pre-certification by VSP is required	—	This warning tells the users not to bill a patient for these necessary contact lens (NCL) services because they're covered.	Acknowledge the warning. This is based on information provided on the claim and the product package. (No service verification number, appropriate diagnosis code, and/or minimum NCL Rx is met.)
OFFEXP0076	Wholesale prices were provided by Maui Jim to ensure correct claim payment. Changing the amount may result in processing delays or incorrect payment	—	This warning appears if the wholesale frame cost is manually changed on a Maui Jim frame.	Acknowledge the warning.
OFFEXP0026	You have requested opposite signs on this prescription. Do you want to continue?	—	In the Rx information, the right and left eyes have different +/- signs. That's rare, so we provide a warning.	For example: - Right eye has sphere +1.00 - Left eye has sphere -1.00
All Other Warnings (in alphanumerical order)
ADJINV0007	Service code is not allowed	—	The billed service is not covered under the product.	For example, in a Vision Therapy claim, the submitted exam code is not 92060 or 92065.
ADJINV0008	An internal error has occurred and some services may not be validated, click OK to continue	Multiple items found.	For service codes 92020, 92250, and 76514, use the specific diagnostic condition that indicates the correct frequency for the patient.	—
ADJPRD0001	An internal error has occurred and some services may not be validated, click OK to continue	Unable to complete validation for the service code due to an internal system error. The product catalog does not exists for the item.	This is a data issue on the VSP side. If you receive this warning, contact VSP.	—
ADJPRD0003	An internal error has occurred and some services may not be validated, click OK to continue	Provider network is not allowed for patient's benefit	The member is not in the correct network to visit this doctor. This should be extremely rare because an authorization should not be issued in such situations.	This can occur when a member's benefit is for VSP (signature doctor) and the member does not have retail or out-of-network privileges. The office has the VWRK network.
ADJPRD0004	Service is not found for patient's benefit	—	This is a data issue on the VSP side. If you receive this warning, contact VSP.	—
ADJPRD0006	Service not covered	Service not covered because of lens design and lens vision type.	The service is not covered because of incompatiblelens design and lens vision type. This error should rarely occur because the system is designed to determine the correct codes by looking at the prescription.	This warning can appear when a client product is billed for something not listed. For example, using SV lenses with HCPCS V2115, which is an aphakic lens option, would trigger this warning.
ADJPRD0007	Service not covered without Service Verification	—	The service is not covered because the service verification requirement was not fulfilled.	See the necessary contact lens (NCL) or Vision Therapy service verifications.
ADJPRD0008	Chosen Dye options not covered for this service	—	The lens color and absorption level are not covered for the service.	For example, this would apply to lens pink 4 (40%) if it were not covered.
ADJPRD0010	Service not covered because of material manufacturer	—	The manufacturer of the selected frame is not covered by the patient's insurance.	For example, VSP employees are allowed to select from only Marchon or Altair. Any other frame triggers this warning.
ADJPRD0011	Chosen Frame Collection not covered for this service	—	The selected frame is part of a collection that is not covered by the patient's insurance.	For example, most VSP Elements insurance plans cover only Otis & Piper frames. If a patient covered by VSP Elements selects a frame from a different collection, this warning appears.
ADJPRD0012	Chosen Frame Brand not covered for this service	—	The brand of the selected frame is not covered by the patient's insurance.	For example, a client has a restriction so the Costa brand is not covered. The client can get any other Luxottica frame.
ADJPRD0013	Chosen Contact Lens Modality not covered for this service	—	The modality (contact lens wear schedule, such as weekly or daily) chosen by a doctor is not covered, a rare but possible problem.	Your Admin needs to correct the modality for these contact lenses.
ADJPRD0014	Contact Lens Frequency has been exceeded	—	The patient's product does not cover the frequency of service (how often contact lenses are supplied) prescribed by the doctor.	For example, the product allows a patient to get contacts only once a year, but the doctor instructs the patient to get them once every six months.
ADJPRD0015	An internal error has occurred and some services may not be validated, click OK to continue	Multiple product items found.	This is a data issue on the VSP side. If you receive this warning, contact VSP.	—
ADJPRD0017	An internal error has occurred and some services may not be validated, click OK to continue	System unable to complete validation due to internal system error.	This is a data issue on the VSP side. If you receive this warning, contact VSP.	—
ADJPRD0019	An internal error has occurred and some services may not be validated, click OK to continue	Level of coverage in Product is missing for the service code.	This is a data issue on the VSP side. If you receive this warning, contact VSP.	—
ADJPRD0020	An internal error has occurred and some services may not be validated, click OK to continue	System unable to complete validation due to internal system error.	This is a data issue on the VSP side. If you receive this warning, contact VSP.	—
ADJPRD0021	An internal error has occurred and some services may not be validated, click OK to continue	Benefit Name is invalid or blank	This is a data issue on the VSP side. If you receive this warning, contact VSP.	The product is not set up correctly or the information is not being passed accurately.
ADJUDI0002	Units of service exceeds maximum units allowed	—	If the amount of a service or materials that a patient can receive is restricted, this warning appears when the patient exceeds the limit.	For example, the following might exceed typical limits: - Billing 2 exams - Billing 20 lenses Elective contacts usually do not trigger this warning because most do not have a unit limit.
ADJUDI0003	An internal error has occurred and some services may not be validated, click OK to continue	An unexpected exception occurred when retrieving dependencies	This occurs in the client API on the VSP side. If you receive this warning, contact VSP.	—
ADJUDI0018	Frame service is not payable	—	This occurs when you haven't gotten an authorization for a frame and there is a frame on the order.	Redo as lenses-only order.
ADJUDI0019	Patient supplied frame is indicated. Frame dispensing HCPCS not allowed	—	You cannot include a V2020 or V2025 CPT code in a claim with a patient-supplied frame.	Redo as a lenses-only order.
ADJUDI0026	Service is not payable due to related service not payable on the claim	—	If you submit a claim for in-office finishing (IOF), it will be denied if either the MLK or V21, V22, or V23** base lens code is not payable.	—
ADJUDI0032	Service code is not covered for the benefit	—	When the level of coverage is "Not Covered," this warning appears on the appropriate line.	For example, the client does not cover progressive lenses and progressives are billed. Recreate the order and change to single-vision.
ADJUDI0035	Frame manufacturer is not covered	—	When an unapproved frame is billed, this warning appears.	Per VSP, the following frame manufacturers are never allowed to be paid: - Cargo - Cool Clip - EasyClip - EasyTwist - Ezy - EasyTwist & Clip - Lincoln Road - Magnetite - Magnetwist - Manhattan Design Studio - Memoflex - Pentax - Takumi - Xepsa
ADJUDI0039	Lens enhancements billed are included in the lens reimbursement for Lab ID 100	—	Deny VSP option codes if the lab ID is 100 and a VSP contract lab is specified in the product.	—
ADJUDI0040	Service code is only payable once per claim	—	If more than one VSP material code is billed for the same service, this warning appears.	For example: - XQQ is billed on 2 lines. - XQQ and XQA are each billed.
ADJUDI0045	Lens style is required	—	Lens style is a required field in POS and Front Office. An order cannot be completed unless it contains this information.	—
ADJUDI0055	Service is not payable due to a related service that is denied or not billed on the claim	—	The service is not payable because a related service was denied.	—
ADJUDI0056	Service is included in another service payable on the claim	—	This is a roll-up warning for bundled items.	If V2781 is billed with V2200, the billed amount is combined, and V2200 is denied so that V2781 can be paid.
ADJUDI0057	Service verification will be reviewed by a processor	—	Some services require service verification. This warning informs the user that a processor will be reviewing the claim.	Necessary contact lenses (NCL) or Vision Therapy often require service verification.
ADJUDI0063	Reason for an emergency visit in claim Box 19 will be reviewed by a processor	—	ProTec products require a particular lab and frame supplier. Lab 100, which signifies an independent lab that is not part of the VSP Contract Lab Network, is used for emergencies only.	The claim should fail validation with this warning when all the following conditions are met: - The claim is for ProTec or Safety products (use labworktype='R009'). - An independent lab is used (lab 100). - Frame material (MF) or patient supplied frame (FX) is on the claim. - Box 19 (Additional Information) on the CMS 1500 form is not empty.
ADJUDI0069	The claim was submitted beyond the allowed submission period	—	The claim was submitted after the timely filing period. For most clients, the filing period is 6 months (or 180 days). Claims filed outside of that period must be submitted on paper; they cannot be submitted electronically.	For example, submit a claim with a date of service (DOS) more than 180 days before the date of submission.
ADJUDI0075	Frame service code is not allowed with other services billed	—	This applies only to Medicaid New York.	This applies to instances that involve the following CPT codes: - V2799 - V2600 - V2610 - V2615
ADJUDI0076	Service will be priced from the invoice by a processor	—	This warning applies to access indemnity products with a shared allowance.	—
ADJUDI0088	I understand that payment and satisfaction of this claim will be from federal and state funds, and that any false claims, statements, documents or concealment of a material fact, may be prosecuted under applicable federal and/or state laws	—	LA Medicaid: This is a Louisiana Medicaid informational warning for explanation of payment (EOP) or explanation of benefits (EOB) messages.	—
ADJUDI0093	The service code billed is not a valid code	—	This warning is designed to deny Healthcare Effectiveness Data and Information Set (HEDIS) codes.	For example, the warning appears when you bill service code 3072F, 2022F, 2024F, or 2026F.
CLMVAL0001	An internal error has occurred and some services may not be validated, click OK to continue	Claim Validation dependent data not found. The Claim Message ID was not found.	This is a data issue on the VSP side. If you receive this warning, contact VSP.	If ADJUDI1000 is not in the CSA4512T table, ADJUDI1000 and CLMVAL0001 are both included in the claim response at the claim level.
CLMVAL0002	An internal error has occurred and some services may not be validated, click OK to continue	Claim Validation dependent data not found. The audience code is missing for a message ID	This is a data issue on the VSP side. If you receive this warning, contact VSP.	If audience code D is missing for AcDJUDI0007 (claim line edit), ADJUDI0007 and CLMVAL0002 are both included in the claim response for doctor audience at the claim level.
OFFEXP0008	The diagnosis code entered is not related to vision care. Do you wish to continue?	—	The diagnosis code is not for vision issues.	For example, you accidentally enter a code for a broken arm.
OFFEXP0011	Please indicate the Contact Lens Manufacturer	—	A contact lens manufacturer is not on the claim when contacts are billed.	—
OFFEXP0013	Diagnosis code billed is not allowed for the service code. Do you want to continue?	—	The diagnosis code does not match the services on the claim.	For example, a well-vision exam code is used for a materials-only claim.
OFFEXP0023	This claim has passed VSP's diagnostic criteria for vision therapy. No additional pre-certification by VSP is required	—	This warning tells the user not to bill a patient for these Vision Therapy services because they're covered.	This is based on information provided on the claim and the product package (an appropriate diagnosis code and/or a service verification number).
OFFEXP0024	The polycarbonate option will be covered in full due to the patient's monocular diagnosis. This patient should not be charged for the polycarbonate option	—	This informational warning tells the user not to bill a patient for the polycarbonate enhancement because it's covered.	This is based on information provided on the claim and the product package (an appropriate diagnosis code).
OFFEXP0029	Flexible Spending Account (FSA) Please verify the FSA amount is accurate. For information on calculating eligible FSA expenses, click the "FSA Paid" link	—	This is a reminder for clients who have an FSA indicator in your system. It warns users to ensure they entered the amount correctly.	—
OFFEXP0030	You have requested different Add values on the right and left eyes. Do you want to continue?	—	In the Rx information, the right and left eyes have different +/- signs. That's rare, so we provide a warning.	For example: - Right eye has Add +1.00 - Left eye has Add -1.00
OFFEXP0063	The Plano option may not be covered by the patient's plan. Please refer to the Patient Record Report for details. Do you wish to continue	—	This warning is displayed in any plano-only claim. Because plano lenses are not always covered, this warns users they should ensure the patient is covered for plano-only. If the patient is not, the claim will be denied.	—
OFFEXP0065	Unity Lens cannot be ordered with an Essilor AR coating	—	Per the manufacturer's rules, a Unity lens with an Essilor coating cannot be made.	—
OFFEXP0077	Selected Scratch Coating is not allowed with the selected Lens Material	—	If scratch coating A is selected with a nonplastic lens material, this warning appears.	—
OFFHDR2002	Frame service is not payable	—	Frame services V2020 and V2025 are not payable when the frame material service code (MF) is not payable.	For example, wholesale for a frame is $0.00, or the MF line is not properly added.
OFFHDR2003	Patient supplied frame is not separately payable	—	VSP does not pay doctors for patient-supplied frames.	—
OFFHDR2006	Lens service is not payable	—	Deny the lens line if the VSP material line is denied or missing.	For example, V2781 is denied if the claim does not have VSP code MLL or MLM.
OFFHDR2009	Lens enhancements billed are included in the lens reimbursement for Lab ID 100	—	Lens enhancements are handled privately when the lab ID is 100, which signifies an independent lab that is not part of the VSP Contract Lab Network.	—
OFFHDR2012	Lens enhancement is not allowed with the other lens enhancements billed	—	Some enhancements exclude other enhancements. The excluded enhancements are denied. Some enhancements are mutually exclusive. If more than one is billed, they are all denied.	Either of the following examples would trigger this warning: - Selecting scratch coating A (XQQ) for polycarbonate lenses. - Billing any scratch coating and any anti-reflective coating together.
OFFHDR4001	Service is not payable when frame is supplied by the patient or blank	—	Carriers do not pay for frames patients supply or that do not have a frame supplier.	—
OFFHDR4003	Patient and lab supplied frames are not covered for VSP Vision Savings Pass claims	—	Frames must be supplied by doctors for VSP Vision Savings Pass products. This warning is the same as PRELIQ0038.	—
PRELIQ0037	For VSP Vision Savings Pass, lab 100 is not allowed	—	A VSP Vision Savings Pass product cannot be sent to lab 100. Lab ID 100 is used for independent labs, which are not part of the VSP Contract Lab Network. Doctors pay independent labs directly.	—
PRELIQ0038	For VSP Vision Savings Pass, patient and lab supplied frames are not covered	—	Frames must be supplied by a doctor for a VSP Vision Savings Pass product. This warning is the same as OFFHDR4003.	—
PRELIQ0039	Unable to complete validation due to an internal system error. Group population code is missing	—	This is a VSP data error If you receive this warning, contact VSP.	—
PRELIQ0067	A primary medical eyecare diagnosis code is required	—	Primary Eye Care and Diabetic Eye Care Plus product packages must have a medical diagnosis as their primary service.	—
PRELIQ0069	Only polycarbonate (for kids 18 and under), oversized, and rimless lens options are available through this benefit. If ANY other options are selected, all materials will be denied, you will be responsible for the lab bill and the cost of all materials	—	This warning applies only to charity claims that use an Eyes of Hope gift certificate.	—

VSP Errors

The following table provides information about all the errors you might see in the VSP interface:

Error ID	Error Text	Generic Processor Message	Explanation	Examples
ADJCOB0001	Coordination of Benefits is not allowed	—	For COB between two or more VSP plans: When all products are under the same client and COB rule 1 applies to all products, COB is not allowed.	COB claim for John Doe: He works at the same client as his spouse, and rule 1 applies to both benefits. - VSP primary product = Signature and relationship on benefit is Member. - Secondary product = Signature and relationship on benefit is Spouse.
ADJCOB0002	Coordination of Benefits is not allowed between two benefits on the same members plan	—	For COB between two or more VSP plans: When the members' products are under the same client using the same member ID and COB rule 11 does not apply, COB is not allowed. This is typical for members who have first- and second-pair benefits.	COB claim: Member ID is the same on both products, and client IDs are the same. - VSP primary product = Signature. - Secondary product = Signature second pair.
ADJCOB0003	Medicaid is always the payer of last resort. Benefits cannot be coordinated with Medicaid as Primary plan	—	For COB between two or more VSP plans: Medicaid should be reserved as the secondary product to any active plan. An exception is made when all products are Medicaid.	COB claim: - VSP primary product = Medicaid. - Secondary product = Signature.
ADJCOB0004	COB is not allowed for secondary Product Package	—	For COB between two or more VSP plans: There are restrictions on which products can be coordinated with others. In these cases, the secondary plan cannot be coordinated with the primary (or possibly at all). There are many instances of this.	COB claim: - VSP primary product = VSP Elements. - Secondary product = PEC.
ADJCOB0005	Primary claim must be under the Member Relationship. Coverage as Dependent is always secondary	—	For COB between two or more VSP plans: When the primary product is for a dependent relation and the secondary product is for a member relation, COB is not allowed. A member relation must be primary over a dependent. An exception is made for Medicaid products (where Medicaid must be secondary regardless of the relationship order).	COB claim for John Doe: - VSP primary product = Signature and relationship on benefit is Spouse. - Secondary product = Signature and relationship on benefit is Member.
ADJCOB0006	COB is not allowed for primary Product Package	—	For COB between multiple VSP plans: There are restrictions on which products can be coordinated with others. In these cases, the primary plan cannot be coordinated with the secondary (or possibly at all). There are many instances of this.	COB claim: VSP primary product = CVC. Secondary product = Signature.
ADJLAB0001	Lab invalid for the date of service	—	This error occurs when the specified lab is not a VSP contract lab.	For example, if lab IDs are 100 to 999 and you specify A001, this error would occur.
ADJPRD0005	Patient relationship is not found for the benefit	—	This patient relationship is not accepted for the specified client product.	For example, Relationship = Domestic Partner, but the client product doesn't cover domestic partners.
ADJPRD0016	Member not covered in Product for date of service	—
ADJPRD0018	Easy Option upgrade not found in product	—
ADJUDI0004	Service must be billed with a specific diagnosis code	—	The diagnosis code in a service bill must be from the condition list for the service.	- When billing for 92065 or 92060 services, you must include a diagnosis code from the Vision Therapy condition list. - When billing for materials, you must include a diagnosis code from the Well Vision Materials condition list.
ADJUDI0008	Service requires Service Verification from VSP	—	To include the service on a claim being submitted to VSP, you must provide a service verification number.	Vision Therapy and Low Vision often require this.
ADJUDI0020	Service requires a payable exam on the claim	—	If a claim for this service does not include a billable line item for an exam, the claim cannot be submitted for payment.	For example, CPT codes 99199 and 92015 cannot be billed without a payable exam.
ADJUDI0031	Service exceeds the maximum units allowed	—	The VSP inventory system assigns a certain number of units to each service. This error occurs when the bill for a service exceeds the maximum number of units assigned to the service. This also happens for IOF orders.	For example, the inventory service assigns one unit to each exam. So if you bill two units for an exam, this error occurs. For IOF orders, override the calculation and verify the amounts manually.
ADJUDI0033	Wholesale Frame Cost is required for frame material service	—	When a frame is submitted for reimbursement, the wholesale frame cost must be provided.	A wholesale frame cost of $0.00 cannot be reimbursed.
ADJUDI0034	Frame case is not payable	—	A frame case is not a billable item when the frame is supplied by the patient.	When a frame is supplied by the patient, you cannot include V2756 (an HCPCS code for an eyeglass case) on the bill.
ADJUDI0038	Lens enhancement is not allowed with the Lens Vision Type	—	A lens enhancement was not billed with the correct bifocal base lens.	To be payable, VSP codes XGA, XIA, XIB, XID, XII, and XIL must be billed with a payable bifocal lens dispensing code.
ADJUDI0041	The diagnosis pointer is pointing to an incomplete or invalid diagnosis code	—	The diagnosis code is incomplete or invalid, AND it is being used as a diagnosis for a specific service line.	For example, diagnosis Box B contains H5, and the pointer for the exam is "B."
ADJUDI0042	The first diagnosis code on the claim is not allowed as primary	—	Medicaid only: Some diagnosis codes are not allowed to be billed as the primary diagnosis on a claim.	—
ADJUDI0051	The primary diagnosis code on the claim is incomplete or invalid	—	The diagnosis code is incomplete or invalid, AND it is listed as the primary diagnosis code on the claim	For example, diagnosis Box A contains H5.
ADJUDI0070	Service code is not allowed with other services billed	—	All corresponding services are denied when a contact lens, contact lens service, or both are billed with an eyeglass lens or frame on the same claim.	You cannot bill contact lenses and eyeglasses (lens, frame, or both) on the same claim.
ADJUDI0077	Visually necessary service. Invoice required	—	CA Medicaid and Low Vision: You must bill Low Vision with the KX modifier to indicate verification.	This error occurs when the service is V2600, V2610, V2615, V2199, V2299, V2399, V2499, V2499, V2702, or V2799 and is NOT billed with the KX modifier.
ADJUDI0079	Lens dispensing is not allowed with the lens material type	—	—	—
ADJUDI0081	Lens Vision Type does not match the billed lens Dispensing Code	—	Non-PIA and PIA-Denied Medicaid: The lens dispensing and lens material codes must be for the same vision type and both must be payable. "PIA" stands for Prison Industry Authority.	For example, a claim cannot have a bifocal dispensing code and a single-vision material code. A claim must have one of each of the following CPT codes: - Dispensing: 92340 or 92352 - Lens vision type: V2100-V2199 or V2410
ADJUDI0083	Service lines billed exceeds the maximum allowed	—	NCL Medicaid: A claim cannot have more than 2 units of service. (This is also the yearly limit for a patient.)	—
ADJUDI0087	Lens service not allowed with modifier billed	—	MI Medicaid: U1 and U2 modifiers (polycarbonate and high-index) cannot be billed on the same claim line. They must also be attached to an appropriate HCPCS code.	- V2100 codes cannot be billed with U1 and U2 modifiers. - The V2300 code cannot be billed with the U1 modifier.
ADJUDI0091	Lab not active under the plan program on date of service	Claim has invalid Lab Id for Participating Retail Provider.	—	—
ELIGIB0001	Patient is either not found or not covered	Patient is either not found or not covered under member policy.	This error occurs when the patient is no longer active in VSP systems.	—
ELIGIB0002	Member ID on the claim doesn't match the Member ID on the Authorization	—	The social security number or the expanded ID on the claim is different from the one on the authorization, which means the claim and the authorization are for different patients.	—
ELIGIB0003	Patient on the claim doesn't match the patient on the Authorization	Patient name, DOB, or relation on the claim doesn't match the VSR.	The name on the claim is not the same as the name on the authorization, which means the claim and the authorization are for different patients.	—
ELIGIB0005	Date of service is not within the effective dates of the Authorization	—	Most authorizations are valid for 30 days, though they can vary.	This error would occur in the following situation: - Authorization dates: 11/01/2020 to 11/30/2020 - Date of service: 12/01/2020
ELIGIB0008	Exam is not included on the Authorization	—	The exam is not authorized on the authorization the doctor is using.	For example, this error would occur in these situations: - An exam is added to an authorization for frames only. - When selecting services for an authorization, you missed a service you meant to include.
ELIGIB0011	Authorization not found	—	If the authorization is deleted, this error occurs.	—
ELIGIB0013	Authorization has been used by another claim	—	The authorization has already been used to submit a claim.	—
ELIGIB0015	Authorization has invalid member information	VSR has invalid member information	The authorization has invalid member information, such as member name, date of birth, or relationship to the insured.	—
ELIGIB0016	Vision Therapy Evaluation or Vision Therapy Sessions is not authorized on the VSR	—	The authorization is not for a product that includes Vision Therapy evaluations or sessions.	—
ELIGIB0017	The VSP Coordination of Benefits Secondary Authorization number you entered is not valid. Please enter a valid secondary authorization number for this patient	The Authorization number in the COB box is not a valid authorization.	For Coordination of Benefits (COB) claims, a different authorization number is needed for the secondary claim. This error occurs when the authorization number in the COB field matches the authorization number used for the claim.	This error would occur in the following situation: - Claim number = 12345678 - Secondary authorization field = 12345678
ELIGIB0018	The VSP Coordination of Benefits Secondary Authorization number you entered is not valid. Please enter a valid secondary authorization number for this patient	The Authorization number in the COB box is not a valid authorization.	For COB from VSP to VSP claims, a valid authorization number is needed in the COB field. This error occurs when the secondary authorization number is not an eight-digit number.	For example, this error would occur when the secondary authorization field = 012345678.
ELIGIB0019	The VSP Coordination of Benefits Secondary Authorization number you entered is not valid. Please enter a valid secondary authorization number for this patient	The Authorization number in the COB box is not a valid authorization	For COB from VSP to VSP claims, an unused authorization is allowed only in the COB field.	Secondary authorization status is not AU/IS (Authorized or Issued).
ELIGIB0020	Authorization in the COB box has invalid member information	COB Authorization has invalid member information	The secondary authorization must have the same member ID, consumer ID, and patient as the first claim.	—
ELIGIB0022	The Date of Service must be within the effective date of the secondary Authorization effective date and the expiration date (secondary Authorization expiration date) for VSP Coordination of Benefits Secondary Authorization number	—	For COB from VSP to VSP claims, this error occurs when the date of service is not within the secondary authorization effective dates.	This error would occur in this situation: - Authorization dates: 11/01/2020 to 11/30/2020 - Date of service: 12/01/2020
OFFEXP0002	Please indicate whether the patient has any health conditions or confirm 'None'	—	If a claim includes an exam, the exam must specify whether the patient has any health conditions.	In any exam listed on a claim, one or more of the following health conditions must be selected: - Diabetes - Diabetic retinopathy - Hypertension - High cholesterol - Prediabetes If the patient has no known health conditions, select None.
OFFEXP0003	Please indicate whether or not dilation has been performed	—	If diabetes or diabetic retinopathy is selected as a known health condition in an exam, the exam must specify whether a dilation was performed.	—
OFFEXP0004	You have Duplicate Diagnosis codes. Diagnosis codes may be entered only once	—	The same diagnosis code was entered more than once in Box 21 of a CMS 1500 form.	For example, both Box A and Box have H52.4.
OFFEXP0005	You must accept assignment to submit the claim	—	In Box 27 (Accept Assignment) of the CMS 1500 form, the Yes check box must be selected. If it is not, this error occurs.	—
OFFEXP0006	Patient Paid amount must be equal to or less than the Total Charges	—	In the CMS 1500 form, Box 28 (Total Charge) cannot be less than Box 29 (Amount Paid). If the patient paid more than the total due, this error occurs.	The following amounts would trigger this error: - Total due: $250 - Patient paid: $300
OFFEXP0007	You have entered Duplicate Diagnosis Pointers. Diagnosis Pointers may be entered only once	—	One claim line has the same diagnosis pointer multiple times.	For example, pointer A appears twice in the claim line for V2020.
OFFEXP0009	Please enter a valid Diagnosis Pointer	—	A diagnosis pointer that is not pointer A–L is entered on a service line.	For example, pointer M appears in a claim line.
OFFEXP0010	Please specify a contact lens brand	—	Contact lens materials are billed, but a brand is not provided.	—
OFFEXP0012	The prescription information you have entered does not meet VSP minimum prescription requirements for the benefit selected. For information regarding VSP minimum prescription requirements please see the VSP Provider Reference Manual or call VSP	—	In a prescription, lenses must be plano or meet the VSP minimum criteria.	VSP minimum prescription criteria: The combined power in any meridian is ±0.50 diopters or greater in at least one eye, OR one of the following exceptions occurs: - A necessary prism of 0.50 diopters or greater in at least one eye. - Anisometropia is 0.50 diopters or greater. - Cylinder power is ±0.50 diopters or greater.
OFFEXP0017	This claim includes more than 15 Service Lines. If all information is accurate please split services between multiple claims for submission	—	Because of system limitations, a claim cannot have more than 15 service line items.	—
OFFEXP0018	The Frame Supplier is required	—	A frame supplier is required if either of the following occurs: - A lens service is used (one or more lenses are billed) - A frame service is used (a frame is billed) Select one of the following frame suppliers: - Doctor Supplied – To Come - Patient Supplied – To Come - Lab Supplied - Lenses Only The lens supplier is specified in the Lens Finishing field. Select one of the following options: - Lab Finishing - In-Office Finishing	—
OFFEXP0019	Supplier cannot be Lenses Only if a lens service has not been selected	—	If lenses are not ordered, you cannot use a lens-only supplier.	—
OFFEXP0020	Supplier cannot be Doctor or Lab if a frame service has not been selected	—	If a frame is not billed, the frame cannot be supplied by a doctor or a lab because no frame is being dispensed. In this case, the only options for frame supplier are the following: - Patient Supplied - To Come - Lenses Only	—
OFFEXP0021	Based on the information provided on this claim, this patient is not eligible for the necessary contact lenses you have selected. Please refer to the Provider Reference Manual for necessary contact lens coverage limitations and instructions	—	Necessary contact lenses (NCL) is a service (product item) attached to the VSP coverage (product) that the patient has for her benefits. It is not Medicaid. There is no service verification number, the diagnosis code is not in the NCL condition group, and the prescription does not meet the NCL minimum.	—
OFFEXP0025	Based on the information provided on this claim this patient is not eligible for the necessary contact lenses you have selected. Please refer to the Provider Reference Manual for necessary contact lens coverage limitations and instructions	—	If all of the following conditions are met on a Medicaid claim, this error occurs: - The claim is for a Medicaid product. - NCL is a product item (service) under the client's Medicaid coverage. - The service line does not contain the KX modifier.	—
OFFEXP0027	Please indicate if communication with Patient's PCP is planned	—	If diabetes or diabetic retinopathy is listed as a known condition, you must specify whether the office intends to communicate with the patient's primary care physician (PCP).	—
OFFEXP0028	Patient FSA amount must be greater than or equal to patient paid amount	—	The amount deducted from the patient's flexible spending account (FSA) cannot be greater than the total amount the patient paid.	The following situation would trigger this error: - FSA paid $250 - Patient paid $200
OFFEXP0031	In-office lens finishing is not available for this order	—	The office, the product, or both do not meet the requirements for in-office finishing (IOF) lenses.	For example, if the primary product is not Signature, Choice, or Advantage, this error would be triggered.
OFFEXP0032	Client is not set up for Flexible Spending Account. Please remove FSA Paid Amount	—	This error occurs when a client does not have an FSA set up but an FSA paid amount is entered.	—
OFFEXP0036	Please enter a valid Patient First and Last name	—	The patient's name is missing from the claim or has invalid characters.	The following characters are allowed in patient names. Any others trigger this error. - All the letters in the English alphabet - Apostrophes - Hyphens (must be followed by a letter) - Periods - Spaces
OFFEXP0037	Please enter a valid Middle Initial for the Patient	—	The middle Initial must be a single letter on the claim.	—
OFFEXP0038	Please enter a valid Patient Date of Birth	—	The date of birth (DOB) is missing from the claim.	—
OFFEXP0039	Please enter a valid Insured First and Last name.	—	The insured's name is missing from the claim or has invalid characters.	The following characters are allowed in names of the insured. Any others trigger this error. - All the letters in the English alphabet - Apostrophes - Hyphens (must be followed by a letter) - Periods - Spaces
OFFEXP0040	Please enter a valid Middle Initial for the member.	—	The middle Initial must be a single letter on the claim.	—
OFFEXP0041	Please enter a valid Insured Date of Birth.	—	The date of birth (DOB) is missing from the claim.	—
OFFEXP0042	Please enter a valid address	—	The address is missing from the claim, is too long, or contains invalid characters.	Address: Cannot be over 30 characters. Use only letters, numbers, periods, dashes, spaces, slashes, commas, hash signs (#), ampersands (&). City: Cannot be over 25 characters. Use only letters, numbers, periods, dashes, spaces, slashes, commas, hash signs (#), ampersands (&). State: Use a valid 2-character state code Zip code: Cannot be over 5 characters (plus 4 for the extension). Use only numbers. Do not use an extension without a zip code.
OFFEXP0043	Please enter a valid Phone Number	—	The phone number on the claim is invalid.	This error has various triggers, such as the following: - Does not have an area code - Has only an area code - Does not contain only numbers
OFFEXP0044	Please enter a valid First and Last name of Referring Provider	—	If the national provider identifier (NPI) of a referring doctor is entered on the claim, the referring doctor's name must also be entered on the claim.	Use only valid characters: - All the letters in the English alphabet - Apostrophes - Hyphens (must be followed by a letter) - Periods - Spaces
OFFEXP0045	Please enter a valid NPI for Referring Provider	—	If the name of a referring doctor is entered on the claim, the referring NPI cannot be blank.	—
OFFEXP0046	Please enter a valid Middle Initial of Referring Provider	—	The middle initial must be a single letter only on the claim.	—
OFFEXP0047	Please enter a valid Other Insured First and Last Name	—	If any "Other Insurance" information is entered on the claim, the subscriber's first and last name must be entered and valid.	Use only valid characters: - All the letters in the English alphabet - Apostrophes - Hyphens (must be followed by a letter) - Periods - Spaces
OFFEXP0048	Please enter a valid Other Insured Policy or Group Number	—	If any "Other Insurance" information is entered on the claim, the policy or group number must be entered in Box 9a (Other Insured's Policy or Group Number) of the CMS 1500 form, and it must be valid.	The policy or group number is alphanumeric.
OFFEXP0049	Please enter a valid Plan Name or Program Name	—	If any "Other Insurance" information is entered on the claim, the plan or program name must be entered in Box 9d (Insurance Plan Name or Program Name) of the CMS 1500 form, and it must be valid.	Use only valid characters: - All the letters in the English alphabet - Apostrophes - Hyphens (must be followed by a letter) - Periods - Spaces
OFFEXP0050	Another health benefit plan must be marked “Yes” when secondary insurance information is present	—	If any "Other Insurance" information is entered on the claim, the system is programmed to mark Box 11d of the CMS 1500 form Yes.	—
OFFEXP0051	Please enter a valid Patient Account Number	—	Must be valid if provided on the claim.	Use only valid characters: - All the letters in the English alphabet - Apostrophes - Commas - Hyphens (must be followed by a letter) - Numbers - Periods - Spaces
OFFEXP0052	Invalid character entered in Box 19 Additional Claim Information	—	Must be valid if provided on the claim.	Use only valid characters: - All the letters in the English alphabet - Numbers - Spaces - The following special characters: . ! @ # $ % & * ( ) + - < > , { } [ ] / ?
OFFEXP0053	A valid state code is required when patients condition relates to Auto Accident	—	If Box 10b (Related to Auto Accident) on the CMS 1500 form is Yes, a valid two-character state code must be included.	—
OFFEXP0054	Please select one option for patient Health Coverage	—	The patient's health insurance coverage must be specified in the claim. Check the appropriate healthcare coverage in Box 1 on the CMS 1500 form.	Typically, this defaults to Group Health Plan.
OFFEXP0055	Please enter a valid Insured Middle Initial	—	The middle initial must be a single letter on the claim.	—
OFFEXP0056	Please enter a valid Medicaid Resubmission Code	—	This is required if an Original Reference Number (Box 22 on the CMS 1500 form) is specified. It must be valid if provided.	The code must be alphanumeric and contain no more than 11 characters.
OFFEXP0057	Please enter a Valid Original Ref. No	—	This is required if a Resubmission Code (Box 22 on the CMS 1500 form) is specified. It must be valid if provided.	This "number" must be alphanumeric and contain no more than 18 characters.
OFFEXP0058	Please enter a valid Policy or FECA Number	—	Must be valid if provided on the claim.	Must be alphanumeric.
OFFEXP0059	Please enter a valid Plan or Program Name	—	Must be valid if provided on the claim.	Use only valid characters: - All the letters in the English alphabet - Apostrophes - Commas - Hyphens (must be followed by a letter) - Numbers - Periods - Spaces
OFFEXP0060	The Patient Unable to Work To Date cannot be less than the From Date	—	If Box 16 on the CMS 1500 form is Yes, the required From date cannot be later than the To date.	For example, do not use these dates: - From: 11/01/2020 - To: 10/01/2020
OFFEXP0061	The Hospitalization To Date cannot be less than the From Date	—	If Box 18 on the CMS 1500 form is Yes, the required From date cannot be later than the To date.	For example, do not use these dates: - From: 11/01/2020 - To: 10/01/2020
OFFEXP0062	Contact Lens Brand contains an invalid character	—	Must be valid if provided.	Valid characters are letters, numbers, hyphens (–), parentheses ( ), ampersands (&), and percent signs (%).
OFFEXP0064	The selected lens cannot be ordered without an Optical Center Height or Segment Height value	—	Some lenses have a technical add-on attribute that requires these measurements to be added.	Many lenses have this attribute. For example, see Zeiss Digital 1000 - Clear.
OFFEXP0065	Unity Lens cannot be ordered with an Essilor AR coating	—	This is the manufacturer's restriction.	—
OFFEXP0066	Slab Off is not available for this lens product	—	If a lens has a custom measurement option (V2702, VSP Code CM, or both), slab off cannot be used on the lens.	—
OFFEXP0067	This lens is not available for this type of order	—	This error occurs when a lens is not part of the eClaim channel.	For example, see Lenton&Rusby 18 w/L&R Premium Coating - L&R Photochromic Gray.
OFFEXP0068	The Anti-reflective coating you selected is already included in the lens you selected from the lens list	—	When anti-reflection is an inherent part of a lens, it cannot be added separately.	For example, see Crizal Prevencia.
OFFEXP0069	Ethos Lens cannot be ordered with an Essilor AR coating	—	This is the manufacturer's restriction.	—
OFFEXP0070	Lab is invalid for claims where VSP is not the Primary payer	—	When VSP is not the primary payer on a claim, the claim can be sent only to lab ID 100, which signifies an independent lab that is not part of the VSP Contract Lab Network.	—
OFFEXP0071	A Maui Jim Sun Frame requires a Maui Jim lens to be selected	—	A Maui Jim Sun frame must have a Maui Jim lens.	—
OFFEXP0072	Please select the Rx option of this frame. A Maui Jim Plano Sun Frame cannot be billed with a prescription Lens	—	When prescription lenses are billed, a Maui Jim frame must be compatible with the lenses. The frame cannot be approved only for plano.	—
OFFEXP0073	A ProTec Eyeware frame is required. For frame choices refer to the ProTec Eyewear kit or online catalog	—	For ProTec products whose frame is supplied by a doctor or a lab, you must choose an approved ProTec frame.	—
OFFEXP0074	A VSP or Generic lens must be selected for Charity claims	—	VSP charity orders must have a generic or VSP-branded lens.	This applies to claims from Eyes of Hope gift certificates.
OFFEXP0075	A VSP or Generic AR coating must be selected for Charity claims	—	VSP charity orders must have a generic or VSP-branded anti-reflective coating.	This applies to claims from Eyes of Hope gift certificates.
OFFEXP0078	Address cannot be more than 30 characters	—	This is the system limitation for the length of the Address field.	—
OFFEXP0079	City cannot be more than 25 characters	—	This is the system limitation for the length of the City field.	—
OFFHDR1001	Diagnosis code billed is not allowed for the service code	—	The diagnosis code is incompatible with the service code.	For example, this error would occur if you included the diagnosis code Z01.00 (which covers eye exams) in a claim for materials only.
OFFHDR1002	Lens finishing code on the claim is not allowed with the lens material code billed on the claim	—	The lens finishing and lens material are not a valid combination.	For example, you cannot include stock lenses and glass on a claim.
OFFHDR1003	Lens enhancement VSP service code is not allowed with the lens type billed on the claim	—	Some VSP material codes require specified vision types.	For example, multifocal code must be applied only to a multifocal lens, such as bifocal or progressive.
OFFHDR1004	Contact Lens reason type is not allowed for the service code	—	This error occurs when the contact lens reason is elective (ECL) and any contact lens fitting code (92070, 92072, 92313, 92314, 92315, 92316, 92317, 92325) is included in the claim.	—
OFFHDR2001	Product item requires a specific lab for processing, and corresponding lab network service not indicated	—	The lab network specified in the product does not match the lab network for the selected (billed) lab.	For example, the lab does not participate in CHOIC, but he product's lab network for billed services is CHOIC.
OFFHDR2004	Lens Enhancement is not payable due to a not allowed service being billed	—	Some clients do not allow specified enhancements. This is sometimes tied to specific product packages, such as Computer Vision Care (CVC). The entire lens and frame order is denied.	—
OFFHDR2005	Lens Enhancement is not an allowed benefit for the patient	—	Some clients do not allow specified enhancements. This is sometimes tied to specific product packages, such as CVC. The enhancement is denied.	—
OFFHDR2007	The wholesale frame amount is required for frame material service	—	This error occurs when the billed amount for the VSP material code MF is $0.00. The error does not apply when the frame is supplied by a lab and an in-kit frame collection is used.	—
OFFHDR2008	Lens enhancement is not allowed with the lens material type	—	To be payable, the VSP material codes XGA, XIA, XIB, XID, XII, and XIL must be billed with a payable bifocal lens dispensing code.	—
OFFHDR2010	Lens enhancement code is not allowed with the other lens enhancement codes billed with the same type	—	A claim cannot use two different VSP material codes to bill for the same enhancement.	For example, using the material codes XFH and XAB in the same claim triggers this error because both codes apply to hi-index lenses.
OFFHDR2011	Service code not allowed to be billed with In-Office Finishing Stock Lens	—	Some enhancements cannot be included in an in-office finishing (IOF) claim.	For example, polycarbonate lenses and anti-reflective coatings cannot be included in IOF claims.
OFFHDR2013	Accompanying lens enhancement was not billed	—	Per an inventory include requirement, the claim cannot bill for the lens enhancement because it is required for another enhancement in the claim or for the base lens.	For example, a claim for V2782 JB - Mid-Index Plastic 1.53-1.60/Trive x (Progressive J add-on) cannot include V2781 JA - Progressive J Plastic.
OFFHDR2014	Glass lens enhancement code is not allowed with a non-glass lens enhancement code	—	A claim cannot include both a glass lens enhancement code and a nonglass lens enhancement code.	—
OFFHDR2015	Service billed is not covered for Elective Contact Lenses	—	Under the well-vision benefit, some CPT codes for exam fitting and evaluation can be billed with necessary contact lenses (NCL) but not with elective contact lenses (ECL). This includes 92072 and 92313.	For example, while billing for contact lenses, if you select elective as the contact type and 92072 as the fitting code, this error will occur.
OFFHDR2016	Lens materials not covered under PIA	—	CA Medicaid: California Medicaid cannot pay for lenses and lens enhancements if the lab is PIA (Prison Industry Authority).	For example, sending a California Medicaid claim to lab 999 (Folsom) will trigger this error.
OFFHDR2017	Invalid lab selected for In-Office Finishing (Uncut)	—	Uncut lenses are limited to VSPOne locations.	—
OFFHDR2018	Invalid lab selected for In-Office Finishing (Stock)	—	Stock lenses are available for single-vision lenses only and must use lab 557.	If you select stock for single-vision lenses and choose a lab other than 557, this error occurs.
OFFHDR2019	Lab used does not belong to participating labs defined under the program	—	Lab 199 or 999 is required for ProTec and other safety products.	If a lab other than 199 or 999 is selected for a ProTec product, this error occurs.
OFFHDR2020	Invalid Lab selected for the benefit	—	Claims for an Elements product must go to lab 199 (Columbus).	—
OFFHDR2021	Lens service code is not allowed with other services billed	—	MI Medicaid: A claim for lenses cannot include a frame repair.	Claims for 92310–92353, 92396, V2100–V2599, V2700–V2799, V2020, and S0581 cannot include codes 92370 or 92371, which are for repairing spectacles.
OFFHDR2022	Wholesale Frame cost cannot be greater than or equal to the V2020 or V2025 Retail Frame Amount	—	You cannot bill a patient less than or the same amount as the wholesale cost of a frame.	For example, the following situation would trigger this error: - Retail charge (billed to patient): $25.00 Wholesale frame cost: $50.00
OFFHDR2023	Reason for an emergency visit is missing in claim Box 19	—	ProTec and other safety products must use specific labs. In an emergency, they can use a private lab, but you must specify the reason for the emergency in Box 19 of the CMS 1500 form.	- For example, this error would occur if you bill a ProTec product to lab ID 100 (an independent lab that is not part of the VSP Contract Lab Network) with a frame on the claim and leave Box 19 empty.
OFFHDR2024	HCFA Box 19 must contain "PIA Denied"	—	CA Medicaid: If a non-PIA (Prison Industry Authority) lab is used, Box 19 of the CMS 1500 form must contain this text: PIA Denied	—
OFFHDR2025	The claim was submitted beyond the allowed submission period	—	The claim was submitted after the filing period ended. For most clients, the period is six months.	For example, this error would occur if you submitted a claim with a date of service (DOS) that is more than 180 days earlier than the date of submission.
OFFHDR3001	Frame is not authorized on the Authorization	—	The frame is not authorized on the authorization the doctor is using.	For example, this error would occur if a user issued an authorization for selected services but billed for others when a patient changed his mind about getting a frame.
OFFHDR3002	Lens is not authorized on the Authorization	—	The lens is not authorized on the authorization the doctor is using.	See OFFHDR3001.
OFFHDR3003	Contact Lens is not authorized on the Authorization	—	The contact lenses are not authorized on the authorization the doctor is using.	See OFFHDR3001.
OFFHDR3004	Contact Lens Exam is not authorized on the Authorization	—	The contact lens exam is not authorized on the authorization the doctor is using.	See OFFHDR3001.
OFFHDR4002	Service is not payable when frame is not supplied by the patient	—	The VSP code (FX) is payable only when the frame is supplied by the patient.	If a frame is supplied by a doctor, an FX line item is not payable. Instead, use an MF line item.
OFFHDR4004	VSP contract labs are not allowed for Proprietary Lens and/or Frame orders	—	Proprietary lenses must go to lab ID 100, which signifies an independent lab that is not part of the VSP Contract Lab Network.	For example, Maui Jim must go to a Maui Jim lab, not a VSP lab.
OFFHDR4005	Stock or uncut lenses are not allowed for Proprietary Lens orders	—	Proprietary lens orders cannot use stock or uncut lenses supplied by a lab.	—
OFFHDR4006	For qualifying Proprietary Lens claims with a frame, the frame must be supplied by doctor	—	Proprietary frames must be supplied by the doctor. They cannot be supplied by the patient or the lab.	—
OFFHDR4007	In-kit frames should be lab supplied	—	VSP Elements In-Kit frames (Otis & Piper) must be supplied by a lab.	Selecting an Otis & Piper frame in an Elements product and then setting the frame supplier to doctor would trigger this error.
OFFHDR4008	Different lens materials are not allowed on the same claim	—	—	Including a single-vision lens and a multifocal lens in the same claim would trigger this error.
OFFHDR4009	The frame supplier code is invalid for Lab ID	—	Frame supplier is not one of the four options for the Frame Supplier field.	These are the valid frame supplier options: - Doctor Supplied - Lab Supplied - Patient Supplied - Lens Only * * Use Lens Only when the patient supplies the frame. This indicates that the lab needs pertinent information about the frames (for example, size and shape) and that the office will insert the lenses into the frame.
OFFHDR4010	The frame supplier code is invalid for stock or uncut lenses	—	Stock or uncut in-house finishing (IOF) frames cannot be supplied by a lab.	—
OFFHDR4011	Lab ID is invalid	—	This error occurs if materials are billed and the Lab ID field is blank or invalid.	—
OFFHDR4012	Contact lens number of boxes is required	—	When ordering contact lenses, you must specify the number of boxes to order.	Selecting contacts and leaving the number of boxes blank would trigger this error.
OFFHDR4013	Contact lens modality is required	—	The client requires that you specify the wear schedule (modality) for contacts and has different coverages or allowances (such as single-use, weekly, or monthly).	—
PRELIQ0001	A valid member's ID is required	—	This occurs only if your system is set up to require a member or consumer ID. Note: A consumer ID is an internal identification number. Users never enter the consumer ID.	—
PRELIQ0002	Patient's first and/or last name is missing.	—	Patient's full name is required.	—
PRELIQ0003	A valid patient date of birth is required	—	Patient's date of birth is required and must be valid.	—
PRELIQ0004	Insured name is required	—	Insured member's name is required.	—
PRELIQ0005	Patient relationship is required	—	Specify how the patient is related to the insurance subscriber.	—
PRELIQ0006	The date of service is missing	—	The date the service was performed is required and must be valid.	—
PRELIQ0007	Service End Date is prior to Date of Service	—	If the service spans multiple days, the end date cannot be earlier than the date of service.	The following dates would trigger this error: - Date of service = 11/01/2020 - Start date = 10/30/2020 - End date = 10/31/2020
PRELIQ0008	Service code is required	—	At least one HCPCS/CPT code must be billed.	—
PRELIQ0009	Billed amount must be greater than or equal to zero	—	The billed amount for a service cannot be blank or negative.	—
PRELIQ0010	Payment Arrangement ID field is invalid	—	The tax ID is not valid.	—
PRELIQ0011	Rendering provider signature is required	—	The signature of the person who provided the service is required.	—
PRELIQ0012	Diagnosis code is required	—	At least one diagnosis code must be provided.	—
PRELIQ0013	All diagnosis codes are invalid	—	At least one diagnosis code must be valid.	—
PRELIQ0017	Contact Lens Reason Code is required	—	If contact lenses are billed, the contact lens reason code must be specified: - ECL (elective contact lens) - NCL (necessary contact lens)	—
PRELIQ0025	Date of service cannot be a future date	—	—	—
PRELIQ0026	Contact Lens Type is not valid for the benefit	—	The contact lens type (HCPCS/CPT code) is not valid.	—
PRELIQ0029	Service is not payable when frame is supplied by patient or blank	—	A frame supplied by the patient is not payable.	—
PRELIQ0033	Rendering provider's NPI is not found or is invalid	—	The National Provider Identifier (NPI) must be a valid 10-digit number that belongs to an active provider in the VSP system.	—
PRELIQ0034	Unit count is invalid	—	Units cannot be less than or equal to 0 on a service line item.	For example, you cannot enter a 92004 service and bill 0 units.
PRELIQ0040	Invalid place of service for date of service	—	A place-of-service code must be in the table of acceptable codes and be active on the date of service. Typically, the code is 11 (Office). For the complete list, see Place of Service Code Set. VSP does not accept all the codes in the list.	Telehealth claims submitted now with a date of service before 2020 would trigger this error.
PRELIQ0041	Lens style is required	Stock Lens must be submitted electronically	Contact lens stock orders must be submitted electronically. Note: Since you are working in an electronic system, you should not encounter this error.	—
PRELIQ0048	Patient Sex is required	Patient gender is required	Patient's gender is required.	—
PRELIQ0049	Patient address is required	—	—	—
PRELIQ0051	A valid billing provider name and address is required	—	—	—
PRELIQ0053	At least one diagnosis pointer must point to a valid diagnosis code	—	Each service line must have a valid diagnosis pointer referencing a valid diagnosis code .	For example, to prevent an error, you must have the following: - Valid diagnosis codes in boxes A–C - An A–C pointer in each line
PRELIQ0056	You have entered duplicate diagnosis codes. Diagnosis codes may be entered only once	—	The same diagnosis code was entered more than once in the CMS 1500 form or the claim. Each diagnosis code can appear only once on a claim.	The following situation would trigger this error: Both Box A and Box B contain diagnosis code H52.4.
PRELIQ0059	An authorization number is required to submit a claim	—	This error is unlikely to occur because most VSP electronic systems require an authorization number to begin a claim, let alone to submit one.	—
PRELIQ0063	Please indicate Signature on File	—	You must have the patient's signature on file. See Box 12 of the CMS 1500 form.	—
PRELIQ0064	Patient Signature Date is required and cannot be a future date	—	The date the patient provided her signature must be entered in Box 12 of the CMS 1500 form.	—
PRELIQ0065	Place of service address is required	—	In Box 32 of the CMS 1500 form, enter the name and address of the facility where services were rendered.	—
PRELIQ0066	ID Number of Referring Physician - Invalid check digit	—	Eyefinity Practice Management validates that the National Provider Identifier (NPI) is a valid ID, not just any 10-digit number.	—
PRELIQ0068	Service Verification may only be billed with NCL. Please change the lens reason from ECL to NCL or remove Service Verification	—	Service verification cannot be billed for elective contacts (ECL), only for medically necessary contacts (NCL).	—
PRELIQ0070	Please enter the number of boxes (1-99)	—	This error occurs when contacts are selected and the number of boxes is not specified.	—
PRELIQ0071	Please enter a valid number of boxes(1-99)	—	This error occurs when contacts are selected and the number of boxes is not a one- or two-digit number.	—