Edit 02032


Invalid Referring Provider NPI

HIPAA Claim Adjustment Reason Code: 208
    Remark Code: N286
HIPAA Healthcare Claim Status Code: 562
    Entity Identifier Code: DN

Potential Causes:
The NPI of the Referring Provider did not pass the check digit validation. All valid NPIs will pass a check-digit algorithm. Because the submitted NPI did not pass this validation check, the NPI number entered is not correct.

Solution:
Check the NPI of the Referring Provider and re-enter the NPI of the Referring Provider correctly.

837 Institutional

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

837 Professional

Loop 2310A NM1 (Referring Provider Name) NM109 (Referring Provider Primary ID) - or - Loop 2420F NM1 (Referring Provider Name) NM109 (Referring Provider Primary ID)

837 Dental

Loop 2310A NM1 (Referring Provider Name) NM109 (Referring Provider Primary ID)