Acknowledgement Report Rejections
(March 2012)
1)
21 Missing or invalid information.
153 Entity’s id number.
153 Entity’s id number.
40 Waiting for final approval.
SOLUTION: Client had Secondary=MCSEC with <Payor & Office Code>= 31140, the old code and no MCSEC in /Tele Com
2)
A7 Rejected for Invalid Information.
500 Entity’s Postal/Zip Code.
A6 Rejected for Missing Information
745 Identifier Qualifier
A6 Rejected for Missing Information.
562 Entity’s National Provider Identifier (NPI)
SOLUTION: /Facility/<NPI> was blank and should be the doctor’s group NPI.
3)
A7 Rejected for Invalid Information.
257 Primary diagnosis code.
SOLUTION: Surgery charge was posted to the POS office.
4)
A8 Rejected for relational field in error. Pending U Rejected
562 Entity’s National Provider Identifier (NPI).
85 Entity not primary.
A8 Rejected for relational field in error. Pending
128 Entity’s tax id.
85 Entity not primary.
QC Total Rejected Quantity
YY Total Rejected Amount
SOLUTION: Problem was client uses 1 prov screen BUT removes the tax id before ebilling Medicare BUT may have ebilled w/o doing so.
5)
A8 Rejected for relational field in error. Pending U Rejected
562 Entity’s National Provider Identifier (NPI).
85 Entity not primary.
A8 Rejected for relational field in error. Pending
128 Entity’s tax id.
85 Entity not primary.
SOLUTION: Problem was /Provider/Provider_Provider <Group NPI> was set to the individual NPI.
REMEMBER: There are 3 provider screens and the system check s provider info in the following order: /Provider_Facility, /Provider_Provider, /Provider.
6)
A7 Rejected for Invalid Information.
503 Entity’s Street Address.
85 Entity not primary.
QC Total Rejected Quantity
YY Total Rejected Amount
SOLUTION: The /Provider had the P.O. Box address and needed to be the physical address.
Medicare Remittance Rejection
(EOB Rejections)
1)
CO-16
REM: N285 N286
N285 Missing/Incomplete/invalid referring provider name
N286 Missing/Incomplete/invalid referring provider primary identifier
SOLUTION: Verify /Facility/<NPI> is set to the doctor’s Group NPI, not the Individual NPI. This applies to the Place Of Service=11=office
1A)
N265 Missing/Incomplete/invalid ordering provider primary identifier
N286 Missing/Incomplete/invalid referring provider primary identifier
SOLUTION: Suggested add charges/Modify/<Rdr>
2)
N290 Missing/incomplete/invalid rendering provider primary identifier.
SOLUTION: /Provider/ <Group NPI> != <NPI> and <Group Provider(Y/N)>=blank, should be ‘Y’. 24J Performing provider number (NPI) if a member of a group practice Field is blank or contains an invalid NPI MA112