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Edit 00142
Recipient Birth Date not Equal File
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N340
HIPAA Healthcare Claim Status Code: 158
Entity Identifier Code: QC
Potential Causes:
The year of birth on the claim does not match what NYSDOH has on file for this client.
Solution:
The provider should verify the YOB (Year of Birth) indicated on the claim with the YOB on MEVS (Medicaid Eligibility Verification System) for this client. Make the necessary correction and resubmit the claim.
| 837 Institutional, 837 Professional and 837 Dental |
Loop 2010BA, DMG (Subscriber Demographic Information)
DMG01 = D8 (Date Time Period Format Qualifier)
DMG02 = Client Date of Birth in CCYYMMDD format (Date Time Period)
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