Edit 02020


Missing the Billing Provider NPI

HIPAA Claim Adjustment Reason Code: 206
    Remark Code: N257
HIPAA Healthcare Claim Status Code: 562
    Entity Identifier Code: N/A

Potential Causes:
The claim has the MMIS ID of the billing provider but the claim did not have the required NPI of the billing provider.

Solution:
Enter the NPI of the billing provider.

837 Institutional , 837 Professional, and 837 Dental

Loop 2010AA NM1 (Billing Provider Name) NM109 (Billing Provider Primary ID)