Edit 02047


Other MMIS Provider ID Cannot be Derived

HIPAA Claim Adjustment Reason Code: 208
    Remark Code: N270
HIPAA Healthcare Claim Status Code: 562
    Entity Identifier Code: N/A

Potential Causes:
The Other Provider’s MMIS Provider ID cannot be derived from the Other Provider’s NPI.

Solution:
The NPI of the Other Provider 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. If the correct NPI was entered contact the NYS Medicaid enrollment unit at 800-342-3005 for rate-based claims.

837 Institutional

Loop 2310C NM1 (Other Provider Name) NM109 (Other Provider Primary ID) - or - Loop 2420C NM1 (Other Provider Name) NM109 (Other Provider Primary ID)