Edit 02044


Operating MMIS Provider ID Cannot be Derived

HIPAA Claim Adjustment Reason Code: 208
    Remark Code: N262
HIPAA Healthcare Claim Status Code: 562
    Entity Identifier Code: 72

Potential Causes:
The Operating Physician’s MMIS Provider ID cannot be derived from the Operating Physician’s NPI.

Solution:
The NPI of the O perating Physician that was entered on the claim is not on file with NYS Medicaid. Check the NPI used to ensure the correct NPI was entered on the claim. If the correct NPI was entered contact the NYS Medicaid enrollment unit at 800-342-3005.

837 Institutional

Loop 2310B NM1 (Operating Physician Name) NM109 (Operating Physician Primary ID) - or - Loop 2420B NM1 (Operating Physician Name) NM109 (Operating Physician Primary ID)