MedicaidAdministrativeHigh impact
UPDATED: Implementation of New Front-End Editing Tool and Error Code Updates
Aetna Better Health of Virginia·VA·Policy Update
Effective date
Apr 1, 2025
We identified it
Aug 13, 2026
Summary
Aetna Better Health of Virginia implemented a new front-end editing tool (SNIP validation) that is rejecting claims with 14 specific error codes related to missing or invalid data elements (dates, diagnoses, procedure descriptions, etc.). Currently, these errors are warnings until April 1, 2025, when they will convert to hard rejections. Billing teams must audit and correct all claims submitted since January 1, 2025, to avoid future denials.
Action Required
By April 1, 2025: Billing team must review all warning error codes received since January 1, 2025, and update claim submission processes to comply with SNIP editing standards. Specific actions: (1) Remove procedure code descriptions for codes that do not require them (e.g., do not submit description for CPT 90651). (2) Add required descriptions in the SV101-7 field at line level for non-specific procedure codes (e.g., add 'Mental Health Skill Building' description for HCPCS H0046). (3) Audit claims for missing Claim Check/Remittance Dates, invalid dates, missing Remaining Patient Liability fields, invalid Service Unit Codes on anesthesia claims, invalid Facility Code Values, missing or invalid health care diagnosis code pointers, and duplicate procedure codes. (4) Update billing software validation rules to enforce these edits before submission. (5) Train providers and billing staff on corrected procedures. Starting April 1, 2025, claims with these errors will be rejected rather than warned, resulting in claim denials and revenue loss until corrected and resubmitted.