MedicaidBilling CodesHigh impact
Provider Notification - Implementation of New Front-End Editing Tool and Error Code Updates
Aetna Better Health of Virginia·VA · Psychiatry, Allergy & Immunology, Pediatrics +2 more·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 with SNIP-level validation that is rejecting claims with two new error codes. Error code 0x393967E requires descriptions for non-specific procedure codes (e.g., H0046), while error code 0x39395D7 prohibits descriptions for specific codes (e.g., 90651). Claims are currently receiving warnings instead of rejections, but rejections will resume on April 1, 2025.
Action Required
By April 1, 2025: Billing team must audit all claim submissions to Aetna Better Health of Virginia and update billing processes to comply with new SNIP editing rules. Specifically: (1) For code H0046 and similar non-specific procedure codes, ensure descriptions (e.g., 'Mental Health Skill Building') are populated in the SV101-7 field at the line level; (2) For code 90651 and specific procedure codes, remove or do not include descriptions. Update billing software validation rules, train billing staff on these requirements, and review recent claim submissions that received error codes 0x393967E or 0x39395D7. Failure to comply before the April 1, 2025 deadline will result in claim rejections at the clearinghouse. Reference www.wedi.org for additional SNIP editing guidelines.