Edit 02058


Invalid NPI and MMIS Assistant Surgeon Provider ID

HIPAA Claim Adjustment Reason Code: 208
    Remark Code: N249
HIPAA Healthcare Claim Status Code: 562
    Entity Identifier Code: N/A

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

Solution:
Check to ensure the submitted NPI and the submitted MMIS Provider ID are correct for the Assistant Surgeon 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 518-402-7032.

837 Dental

Loop 2310D NM1 (Assistant Surgeon Name) NM109 (Assistant Surgeon Primary Identifier) REF (Assistant Surgeon Secondary Identification) REF02 (Assistant Surgeon Additional Identifier) - or - Loop 2420C NM1 (Assistant Surgeon Name) NM109 (Assistant Surgeon Primary Identifier) REF (Assistant Surgeon Secondary Identification) REF02 (Assistant Surgeon Additional Identifier)