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Edit 00719
Provider ID and Ordering/Referring/Prescribing ID’s are identical
HIPAA Claim Adjustment Reason Code: 16
Remark Code: N55
HIPAA Healthcare Claim Status Code: 153
Entity Identifier Code: DK
Potential Causes:
The billing provider information entered and the referring provider information entered are the same and this is not allowed on laboratory claims.
Solution:
Please make necessary corrections to the following loop and segments and re-submit.
| 837 Institutional |
Loop 2010AA, REF (Billing Provider Secondary Identification)
REF01 = 1D (Reference Identification Qualifier)
REF02 = Provider ID (Reference Identification)
And
Loop 2310C, REF (Other Provider Secondary Identification)
REF01 = 0B or 1D (Reference Identification Qualifier)
REF02 = Provider ID number or License Number (Reference Identification) |
| 837 Professional |
Loop 2010AA, REF (Billing Provider Secondary Identification)
REF01 = 1D (Reference Identification Qualifier)
REF02 = Provider ID (Reference Identification)
And
Loop 2310A, REF (Referring Provider Secondary Identification)
REF01 = 0B or 1D (Reference Identification Qualifier)
REF02 = Provider ID number or License Number (Reference Identification) |
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