|
Edit 02043
Attending MMIS Provider ID Cannot be Derived
HIPAA Claim Adjustment Reason Code: 208
Remark Code: N253
HIPAA Healthcare Claim Status Code: 562
Entity Identifier Code: N/A
Potential Causes:
The Attending Physician’s MMIS Provider ID cannot be derived from the Attending Physician’s NPI. Claim processing requires the Attending Physician’s MMIS Provider ID for Institutional claims.
Solution:
The NPI of the Attending Physician that was entered on the claim is not on file with NYS Medicaid. Check the NPI used to ensure the correct NPI was entered on the claim.
|
837 Institutional |
Loop 2310A
NM1 (Attending Physician Name)
NM109 (Attending Physician Primary ID)
- or -
Loop 2420A
NM1 (Attending Physician Name)
NM109 (Attending Physician Primary ID) |
|
