Edit 02057


Invalid NPI and MMIS Other Provider ID Combination

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

Potential Causes:
The submitted Other Provider NPI is not on the New York State NPI registration file as belonging to the same provider as the submitted Other Provider MMIS Provider ID.

Solution:
Check to ensure the submitted NPI and MMIS ID are correct for the Other Provider that was submitted. If the NPI and MMIS ID are correct, then the state registration file is incorrect. The provider must contact the NYS Medicaid Enrollment Unit at 800-342-3005.

837 Institutional

Loop 2310C NM1 (Other Provider Name) NM109 (Other Provider Primary Identifier) REF (Other Provider Secondary Identification) REF02 (Other Provider Additional Identifier) - or - Loop 2420C NM1 (Other Provider Name) NM109 (Other Provider Primary Identifier) REF (Other Provider Secondary Identification) REF02 (Other Provider Additional Identifier)