Edit 02048


Assistant Surgeon MMIS Provider ID Cannot be Derived

HIPAA Claim Adjustment Reason Code: 208
    Remark Code: N249
HIPAA Healthcare Claim Status Code: 562
    Entity Identifier Code: DD

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

Solution:
The NPI of the Assistant Surgeon 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 Dental

Loop 2310D NM1 (Assistant Surgeon Name) NM109 (Assistant Surgeon Primary ID) - or - Loop 2420C NM1 (Assistant Surgeon Name) NM109 (Assistant Surgeon Primary ID)