EDI ENTRY ERROR AND REJECTION CODES PROFESSIONAL. Note: HIPAA Codes can be found on the Washington Publishing Company website

Transcription

1 EDI ENTRY ERROR AND REJECTION CODES PROFESSIONAL Note: HIPAA Codes can be found on the Washington Publishing Company website CODE FIELD NAME EXPLANATION HIPAA CODE 5010 COMMENT E00A Payor Name Payor Name Invalid A3/125 Entity Code PRP E01A Insured ID Number Field must not contain spaces or a space within the insured id no. Must also not be = A3/33 E01B Insured ID Number Field contains alphabetic characters A3/33 E01C Member ID Invalid Member ID A3/33 E02A Patient Last Name Field must not contain spaces or numbers A3/504 Use ENTITY-ID from Eligibility E02B Patient Last Name Field must not contain spaces or numbers A3/504 Use ENTITY-ID from Eligibility E02C Patient First Name Eligibility Error - Field must not contain spaces A3/505 Use ENTITY-ID from Eligibility E02D Patient Last Name Eligibility Error - Field must not contain spaces. Eligibility error 1003 Last Name does not match eligibility A3/504 Use ENTITY-ID from Eligibility E03A Patient Date of Birth Date = spaces or invalid A3/158 Use ENTITY-ID from Eligibility E03B Patient Gender Must = M or F A3/157 Use ENTITY-ID from Eligibility E03C Patient Date of Birth Eligibility Error - Field must contain a valid date A3/158 Use ENTITY-ID from Eligibility E04A Insured Last Name Field must not contain spaces and must be alphabetic E04B Insured First Name Field must not contain spaces and must be alphabetic E05A Admission Invalid future date Date/Hospitalization date/service Date A3/504 Entity Code IL A3/505 Entity Code IL A3/198 E06A Patient Relationship to Field must not be spaces A3/156 Insured E07A Insured Address 1 Field must not be spaces A3/503 Entity Code IL E07B Insured Address 2 Field must not be spaces A3/503 Entity Code IL E07C Insured City Field must not be spaces A3/502 Entity Code IL E07D Insured State Field must not be spaces A3/501 Entity Code IL E07E Insured Zip Field must not be spaces A3/500 Entity Code IL E14A Accident Symptom Date Field contains an invalid date A3/248 E15A Similar Symptom Date Field contains an invalid date A3/648 E16A Disability From Date Field contains an invalid date A3/195 E16B Disability To Date Field contains an invalid date A3/196 E17A Referring Provider Field contains spaces A3/562 Entity Code DN Identification Number E18A Admission Date Field contains an invalid date A3/198 E18B Discharge Date Field contains an invalid date A3/190 E19A Date Last Seen Field contains an invalid date A3/387 Changed ENTITY-ID to 82 E19B Patient Death Indicator Field contains a value other than a D or a A3/159 space E20A Laboratory Indicator Value must = Y or N A3/473 E20B Laboratory Charges If laboratory indicator field contains a Y, then A3/179 charges are required E21A Diagnosis Code 1 Field contains spaces, zeroes, or an invalid A3/255 code E21B Diagnosis Code 2 Field contains an invalid code A3/255 E21C Diagnosis Code 3 Field contains an invalid code A3/255 E21D Diagnosis Code 4 Field contains an invalid code A3/255 E21E Diagnosis Codes Field contains a title diagnosis code A3/255 E21F Diagnosis Code 5 Field contains an invalid code A3/255 New for 5010 E21G Diagnosis Code 6 Field contains an invalid code A3/255 New for 5010 E21H Diagnosis Code 7 Field contains an invalid code A3/255 New for 5010 E21I Diagnosis Code 8 Field contains an invalid code A3/255 New for 5010 E21J Diagnosis Code 9 Field contains an invalid code A3/255 New for 5010 E21K Diagnosis Code 10 Field contains an invalid code A3/255 New for 5010 E21L Diagnosis Code 11 Field contains an invalid code A3/255 New for 5010

2 E21M Diagnosis Code 12 Field contains an invalid code A3/255 New for 5010 E21T Diagnosis Code NOT ANESTHESIA & NOT DMEPOS service A3/21/488 New for ICD10 Qualifier 1-12 dates span ICD9/ICD10 E21U Diagnosis Code ANESTHESIA (ICD10) service date prior to A3/21/488 New for ICD10 Qualifier 1-12 ICD10 E21V Diagnosis Code DMEPOS (ICD10) service date prior to ICD10 A3/21/488 New for ICD10 Qualifier 1-12 E21W Diagnosis Code Diagnosis Code Qualifier Contains ICD9 & A3/21/745 New for ICD10 Qualifier 1-12 ICD10 Codes E21X Diagnosis Code ICD9/ICD10 Diag Code Qualifier does not A3/21/255 New for ICD10 Qualifier 1-12 match the Diagnosis Code E22A Original Reference # Payer Claim Control Nbr (Original Claim Nbr) A3/162 Changed ENTITY-ID to 1E must not be spaces when Billing Frequency = 7 or 8 E23A Prior Authorization # Field must not be spaces A3/252 E24A Service From Date Field contains an invalid date A3/187 E24B Place of Service Code is not valid. Refer to 1500 billing manual. A3/249 Entity Code 77 E24C Type of Service Code Code is not valid. If not an Envoy claim and the type of service code is not spaces, then the type of service code must be valid. A3/250 E24E Diagnosis Code Pointer Code cannot be spaces A3/477 E24F Line Charges Charges are not numeric A3/583 E24G Units of Service Units are not numeric A3/258 E24H Procedure Code Code is equal to spaces A3/454 E24I HCPCS modifier Modifier is invalid A3/453 E24J Procedure Code Code is not on file A3/454 E24K Procedure Code Code is not in valid date range A3/454 E24L Service to Date Field contains an invalid date or date is less A3/187 than service from date E24M Service Lines Claim has more than 90 service lines A3/121 E24N Procedure Code Procedure code is in anesthesia range A3/454 thru and service from date < E24O Procedure Code NOC (Not Otherwise Classified) Code but Review Indicator is NOT = Y Valid Service Codes: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, A, B, C, D, E, F, G, H, J, K, L, M, N, P, Q, R, S, T, U, V, W A3/306 New for 5010 E24P Anesthesia Code Anesthesia Related Code is spaces A3/666 New for 5010 E24Q Anesthesia Code Anesthesia Related Code is not on file A3/507 New for 5010 E24U Procedure Code Cannot use modifier 51 with certain procedure A3/453 codes E24Y Procedure Code Cannot use modifier 63 with certain procedure A3/453 codes E25A Provider Tax ID # Field is not numeric A3/128 Changed ENTITY-ID to 85 E25C Provider Tax ID # Field is spaces A3/128 Changed ENTITY-ID to 85 E26A Patient Control Number Field is spaces or has a leading space A3/464 (Account No.) E27A Provider Assignment Code is not = A A3/589 Indicator E28A Total Claim Charges Charges are not numeric A3/178 E29A Patient Amount Paid Amount is not numeric A3/183 Use ENTITY ID from Eligibility E30A Balance Due Amount is not equal to total claim charges less A3/6 patient amount paid E33D Billing Provider NPI Invalid National Provider Identifier or NPI NOT A3/26 Entity Code 85 ON FILE E33E Billing NPI/TAX ID/ Invalid NPI/Tax ID/Taxonomy Code A3/153 Changed ENTITY-ID to 85 Taxonomy Combination - Billing Provider E33F Rendering Provider NPI Invalid National Provider Identifier or NPI NOT A3/26 Entity Code 82 ON FILE E33G Provider Address Should not contain P.O. Box, Lockbox or PMB A3/503 New for 5010 Entity Code 85 E33H Rendering NPI/TAX ID/ Invalid NPI/Tax ID/Taxonomy Code A3/153 New for 5010 Entity Code 82 Taxonomy Combination - Rendering Provider E35A Billing Taxonomy Code Missing or Invalid Billing Taxonomy Code A3/145 Changed ENTITY-ID to 85 E35B Rendering Taxonomy Missing or Invalid Billing Taxonomy Code A3/145 New for 5010 Entity Code 82 Code E37A Place of Service If the Place of Service is other than 11 or 12, the Facility Lab Name is required A3/124 Changed ENTITY-ID to 77

3 E50A Eligibility Error No coverage found for date of service A3/88 Use ENTITY ID from Eligibility E62A Group Number Group Number/Policy NBR invalid A3/163 Entity Code IL E62B Group Number Should be handled by Employer A3/114 Entity Code 36 E70A Eligibility Error From Eligibility Error 1011 Junior Jumbo A8/33/116 Alpha-Prefix Claims should be processed at Highmark E70B Eligibility Error From Eligibility Error 1012 Host or FEP A8/116 Claims should be processed at Highmark E70C Eligibility Error From Eligibility Error 1013 HMK Alpha-Prefix Claims should be processed at Highmark A8/ FPH EDI ENTRY ERROR CODES INSTITUTIONAL Note: HIPAA Codes can be found on the Washington Publishing Company website CODE FIELD NAME EXPLANATION HIPAA CODE 5010 COMMENTS N01B PROVIDER NAME Provider name is missing or contains spaces A3/125 N01C PROVIDER ADDRESS Provider address is missing or contains spaces A3/126 N01D PROVIDER CITY Provider city is missing or contains spaces A3/126 N01E PROVIDER STATE Invalid state A3/126 N01F PROVIDER ZIP CODE Provider zip code is missing or contains spaces A3/126 N01G Provider Address Invalid - contains PO Box or Lock Box or PMB A3/503 Entity Code 85 N02B Type of Bill Last POS of Bill Type (Claim frequency code) is 7 or A3/ Claim Number is Required N03A PATIENT CONTROL Patient control number is missing or contains A3/478 NUMBER spaces N04A TYPE OF BILL Invalid Type of Bill - Does not convert to Type of A3/228 Claim N04B BCR-TB-DISCONT-CODE Equal to Y A3/228 N05A FEDERAL TAX ID NO Invalid, Missing or contains spaces A3/128 N06A STATEMENT COVERS FROM Covers from date is not numeric A3/188 DATE N06B STATEMENT COVERS FROM Covers from date is not a valid date A3/188 DATE N06C STATEMENT COVERS THRU Covers thru date is not numeric A3/188 DATE N06D STATEMENT COVERS THRU Covers thru date is not a valid date A3/188 DATE NO6E STATEMENT COVERS FROM Cannot have an ICD-9 from date with an ICD-10 A3/21/188 New ICD-10 Error DATE thru date N07A COVERED DAYS Not numeric for an inpatient A3/456 N07B COVERED DAYS Equal to zeros for an inpatient A3/456 N08A NON COVERED DAYS Not numeric A3/457 N09A COINSURANCE DAYS Not numeric A3/458 N10A Life Time Reserve Days Not numeric A3/459 N12A Patient First Name Missing or blank or contains a space A3/125 N12B Patient Last Name Missing or blank or contains a space A3/125 N12C ELIGIBILITY ERROR Invalid patient first name A3/125 N12D ELIGIBILITY ERROR Invalid patient last name A3/125 N13A PATIENT ADDRESS 1 Missing or contains a leading blank or space A3/126 N13B PATIENT STATE Invalid state A3/126 N13C Patient ZIP Code Five Not numeric A3/126 N13E Patient Zip Code Four Not numeric A3/126 N14A Patient Birthdate Not numeric A3/158 N14B Patient Birthdate Not a valid date A3/158 N14C ELIGIBILITY ERROR Invalid patient date of birth A3/158 N15A Patient Sex Not = M, F, or U A3/157

4 N15A Patient Sex HMO Claim and = U A3/157 N17A ADMISSION DATE Not numeric A3/189 N17B ADMISSION DATE Not a valid date A3/189 N18A ADMISSION HOUR If outpatient or Home Health not numeric A3/230 N19A TYPE OF ADMISSION Not equal to 1, 2, 3, 4, 5 or 9 A3/231 N2AA Medical Record Number First position of med rec number cannot be a space A3/588 N20A Source of Admission Not between 0 and 9, or A & D. No spaces A3/229 N21A Discharge Hour No spaces. Must be between 00 and 23, not 99 A3/233 N22A PATIENT STATUS Not spaces, not numeric A3/234 N23A Condition Code (1) Invalid A3/460 N23B Condition Code (1) Other than outpatient and = 44 A3/460 N24A Condition Code (2) Invalid A3/460 N24B Condition Code (2) CD follows a previous zero code - i.e. CD (1) = 0, A3/460 CD (2) = 10 N24C Condition Code (2) Other than outpatient and =44 A3/460 N25A Condition Code (3) Invalid A3/460 N25B Condition Code (3) CD follows a previous zero code - i.e. CD (2) = 0, A3/460 CD (3) = 10 N25C Condition Code (3) Other than outpatient and =44 A3/460 N26A Condition Code (4) Not numeric A3/460 N26B Condition Code (4) CD follows a previous zero code - i.e. CD (3) = 0, A3/460 CD (4) = 10 N26C Condition Code (4) Other than outpatient and =44 A3/460 N27A Condition Code (5) Not numeric A3/460 N27B Condition Code (5) CD follows a previous zero code - i.e. CD (4) = 0, A3/460 CD (5) = 10 N27C Condition Code (5) Other than outpatient and =44 A3/460 N28A Condition Code (6) Not numeric A3/460 N28B Condition Code (6) CD follows a previous zero code - i.e. CD (5) = 0, A3/460 CD (6) = 10 N28C Condition Code (6) Other than outpatient and =44 A3/460 N29A Condition Code (7) Not numeric A3/460 N29B Condition Code (7) CD follows a previous zero code - i.e. CD (6) = 0, A3/460 CD (7) = 10 N29C Condition Code (7) Other than outpatient and =44 A3/460 N30A Condition Code (8) Invalid, Not numeric A3/460 N30B Condition Code (8) CD follows a previous zero code - i.e. CD (7) = 0, A3/460 CD (8) = 10 N30C Condition Code (8) Other than outpatient and =44 A3/460 N31A Condition Code (9) Invalid, Not numeric A3/460 N31B Condition Code (9) CD follows a previous zero code - i.e. CD (8) = 0, A3/460 CD (9) = 10 N31C Condition Code (9) Other than outpatient and =44 A3/460 N32A Occurrence Code (1) Invalid A3/719 N32B Occurrence Date (1) Not numeric A3/720 N32C Occurrence Date (1) Bad date A3/720 N32D Occurrence Code (1) Code greater than zero A3/719 N32E Occurrence Code (1) Code not greater than zero A3/719 N33A Occurrence Code (2) Invalid A3/719 N33B Occurrence Date (2) Not numeric A3/720 N33C Occurrence Date (2) Bad date A3/720 N33D Occurrence Code (2) Code greater than zero A3/719 N33E Occurrence Code (2) Code not greater than zero A3/719 N33F Occurrence Code (2) Code follows a previous zero code i.e: CD (1) = 0, A3/719 CD (2) = 10 N34A Occurrence Code (3) Invalid A3/719 N34B Occurrence Date (3) Not numeric A3/720 N34C Occurrence Date (3) Bad date A3/720 N34D Occurrence Code (3) Code greater than zero A3/719 N34E Occurrence Code (3) Code not greater than zero A3/719 N34F Occurrence Code (3) Code follows a previous zero code i.e: CD (2) = 0, A3/719 CD (3) = 10 N35A Occurrence Code (4) Invalid A3/719 N35A Occurrence Span Code 1 Invalid A3/721

5 N35B Occurrence Date (4) Not numeric A3/722 N35B Occurrence Span From Date 1 Not numeric A3/722 N35C Occurrence Date (4) Bad Date A3/722 N35C Occurrence Span From Date 1 Bad Date A3/722 N35D Occurrence Code (4) Code greater than zero A3/719 N35D Occurrence Span Thru Date 1 Not numeric A3/722 N35E Occurrence Code (4) Code not greater than zero A3/719 N35E Occurrence Span Thru Date 1 Bad Date A3/722 N35F Occurrence Code (4) Code follows a previous zero code i.e: CD (3) = 0, A3/719 CD (4) = 10 N35F Occurrence Span Code 1 Have span code but don t have one or both dates A3/722 N35G Occurrence Span Code 2 Not numeric A3/722 N35H Occurrence Span From Date 2 Not numeric A3/722 N35I Occurrence Span From Date 2 Not zeros, Bad date A3/722 N35J Occurrence Span Thru Date 2 Not numeric A3/722 N35K Occurrence Span Thru Date 2 Not zeros, Bad Date A3/722 N35L Occurrence Span Code 2 Any one less then zero A3/721 N35M Occurrence Span Code 3 Invalid A3/721 N35N Occurrence Span From Date 3 Not numeric A3/722 N35O Occurrence Span From Date 3 Bad Date A3/722 N35P Occurrence Span Thru Date 3 Not numeric A3/722 N35Q Occurrence Span Thru Date 3 Bad date A3/722 N35R Occurrence Span Code 3 Have span-code but don t have one or both dates A3/721 N35S Occurrence Span Code 4 Not numeric A3/721 N35T Occurrence Span From Date 4 Not numeric A3/722 N35U Occurrence Span From Date 4 Not zeros, Bad date A3/722 N35V Occurrence Span Thru Date 4 Not numeric A3/722 N35W Occurrence Span Thru Date 4 Not zeros, Bad Date A3/722 N35X Occurrence Span Code 4 Any one less then zero A3/721 N36A Occurrence Span Code 5 Invalid A3/721 N36B Occurrence Span From Date 5 Not numeric A3/722 N36C Occurrence Span From Date 5 Bad date A3/722 N36D Occurrence Span Thru Date 5 Not numeric A3/722 N36E Occurrence Span Thru Date 5 Bad Date A3/722 N36F Occurrence Span Code 5 Have span-code but don t have one or both dates A3/721 N36G Occurrence Span Code 6 Not numeric A3/721 N36H Occurrence Span From Date 6 Not numeric A3/722 N36I Occurrence Span From Date 6 Not zeros, Bad date A3/722 N36J Occurrence Span Thru Date 6 Not numeric A3/722 N36K Occurrence Span Thru Date 6 Not zeros, Bad Date A3/722 N36L Occurrence Span Code 6 Any one less then zero A3/721 N36M Occurrence Span Code 7 Invalid A3/721 N36N Occurrence Span From Date 7 Not numeric A3/722 N36O Occurrence Span From Date 7 Bad date A3/722 N36P Occurrence Span Thru Date 7 Not numeric A3/722 N36Q Occurrence Span Thru Date 7 Bad Date A3/722 N36R Occurrence Span Code 7 Have span-code but don t have one or both dates A3/721 N36S Occurrence Span Code 8 Not numeric A3/721 N36T Occurrence Span From Date 8 Not numeric A3/722 N36U Occurrence Span From Date 8 Not zeros, Bad date A3/722 N36V Occurrence Span Thru Date 8 Not numeric A3/722 N36W Occurrence Span Thru Date 8 Not zeros, Bad Date A3/722 N36X Occurrence Span Code 8 Any one less then zero A3/721 N38A Responsible Party Last Spaces, not alphabetic A3/504 Entity Code QD 4010 only N38B Responsible Party First No spaces, Not Alphabetic A3/505 N38C Responsible Party Middle Initial Not Alphabetic A3/505 N38D Responsible Party Address 1 Missing or Contains Invalid Characters A3/503 N38E Responsible Party City Missing or Contains Invalid Characters A3/502 N38F Responsible Party State Invalid State A3/501 N38G Responsible Party Zip 5 Zip 5 Not Numeric A3/500 N38H Responsible Party Zip Plus 4 Zip 4 Not Numeric A3/500 N39A Value Code (1-4) Invalid A3/725 N39B Value Amount (1-4) Not numeric A3/726 N39C Value Code (1-4) Code without an amount A3/726

6 N39D Value Amount (1-4) Amount without a code A3/726 N39E Value Code (1-4) No preceding code A3/725 N405 Value Amount Accident hour (value code 45) - >23 and not 99 A3/726 N40A Value Code (5-8) Invalid A3/725 N40B Value Amount (5-8) Not numeric A3/726 N40C Value Code (5-8) Code without an amount A3/725 N40D Value Amount (5-8) Amount without a code A3/726 N40E Value Code (5-8) No preceding code A3/725 N41A Value Code (9-16) Invalid A3/725 N41B Value Amount (9-16) Not numeric A3/726 N41C Value Code (9-16) Code without an amount A3/725 N41D Value Amount (9-16) Amount without a code A3/725 N41E Value Code (9-16) No preceding code A3/725 N42A Accommodation/Ancillary Ancillary revenue code not numeric A3/455 Revenue Code N42D Accommodation/Ancillary Revenue Code Invalid revenue code A3/455 N45B Accommodation/Ancillary Bad date A3/187 Service Date N46A Accommodation Days (1-5) Not numeric A3/258 N46B Ancillary Units Service (1-5) Not numeric A3/258 N46C HCPCS Units (1-5) Not numeric A3/258 N47A Accommodation Total Charges Not numeric A3/178 (1-5) N47B Accommodation Total Charges Less than zero A3/178 (1-5) N47C Ancillary Total Charges (1-5) Not numeric A3/178 N47D Ancillary Total Charges (1-5) Less than zero A3/178 N47E Total Charges (1-3) Not numeric A3/178 N47F Total Charges (1-3) Less than zero A3/178 N48A Accommodation Non Covered Not numeric A3/596 Charges (1-5) N48B Accommodation Non Covered Less than zero A3/596 Charges (1-5) N48C Accommodation Total Charges Both are zero A3/596 (1-5) N48D Ancillary Non Covered Not numeric A3/596 Charges (1-5) N48E Ancillary Non Covered Less than zero A3/596 Charges (1-5) N48F Ancillary Total Charges (1-5) Both are zero A3/596 N48G Non Covered Charges (1-3) Not Numeric A3/596 N48H Non Covered Charges (1-3) Less than zero A3/596 N48I Total Charges (1-3) Both are zero A3/596 N49A HCPCS Service Date HMO claim with bill type 331, 332, 333, 334 and no A3/21 service date N49B HCPCS Code is an NOC code and description is missing A3/306 N4AA Occurrence Code (5) Invalid A3/719 N4AB Occurrence Date (5) Not numeric A3/720 N4AC Occurrence Date (5) Bad date A3/720 N4AD Occurrence Code (5) Code greater than zero A3/719 N4AE Occurrence Code (5) Code not greater than zero A3/719 N4AF Occurrence Code (5) Code follows a previous zero code i.e. CD (4) = 0, A3/719 CD (5) = 10 N4BA Occurrence Code (6) Invalid A3/719 N4BB Occurrence Date (6) Not numeric A3/720 N4BC Occurrence Date (6) Bad date A3/720 N4BD Occurrence Code (6) Code greater than zero A3/719 N4BE Occurrence Code (6) Code not greater than zero A3/719 N4BF Occurrence Code (6) Code follows a previous zero code i.e. CD (5) = 0, A3/719 CD (6) = 10 N4CA Occurrence Code (7) Invalid A3/719 N4CB Occurrence Date (7) Not numeric A3/720 N4CC Occurrence Date (7) Bad date A3/720

7 N4CD Occurrence Code (7) Code greater than zero A3/719 N4CE Occurrence Code (7) Code not greater than zero A3/719 N4CF Occurrence Code (7) Code follows a previous zero code i.e. CD (6) = 0, A3/719 CD (7) = 10 N4DA Occurrence Code (8) Invalid A3/719 N4DB Occurrence Date (8) Not numeric A3/720 N4DC Occurrence Date (8) Bad date A3/720 N4DD Occurrence Code (8) Code greater than zero A3/719 N4DE Occurrence Code (8) Code not greater than zero A3/719 N4DF Occurrence Code (8) Code follows a previous zero code i.e. CD (7) = 0, A3/719 CD (8) = 10 N4EA Occurrence Code (9) Invalid A3/719 N4EB Occurrence Date (9) Not numeric A3/720 N4EC Occurrence Date (9) Bad date A3/720 N4ED Occurrence Code (9) Code greater than zero A3/719 N4EE Occurrence Code (9) Code not greater than zero A3/719 N4EF Occurrence Code (9) Code follows a previous zero code i.e. CD (8) = 0, A3/719 CD (9) = 10 N4FA Occurrence Code (10) Invalid A3/719 N4FB Occurrence Date (10) Not numeric A3/720 N4FC Occurrence Date (10) Bad date A3/720 N4FD Occurrence Code (10) Code greater than zero A3/719 N4FE Occurrence Code (10) Code not greater than zero A3/719 N4FF Occurrence Code (10) Code follows a previous zero code i.e. CD (9) = 0, A3/719 CD (10) = 10 N4GA Occurrence Code (11) Invalid A3/719 N4GB Occurrence Date (11) Not numeric A3/720 N4GC Occurrence Date (11) Bad date A3/720 N4GD Occurrence Code (11) Code greater than zero A3/719 N4GE Occurrence Code (11) Code not greater than zero A3/719 N4GF Occurrence Code (11) Code follows a previous zero code i.e. CD (10) = A3/719 0, CD (11) = 10 N4HA Occurrence Code (12) Invalid A3/719 N4HB Occurrence Date (12) Not numeric A3/720 N4HC Occurrence Date (12) Bad date A3/720 N4HD Occurrence Code (12) Code greater than zero A3/719 N4HE Occurrence Code (12) Code not greater than zero A3/719 N4HF Occurrence Code (12) Code follows a previous zero code i.e. CD (11) = A3/719 0, CD (12) = 10 N50A Payer Name Invalid plan code or have prior payment and A3/137 numeric part or plan code missing N50B Payer Name Payer A/B/C is not Blue Cross A3/137 N50C Payer Name First Priority payer but not an HMO claim A3/21/125 Entity Code PRP N50D Payer Name Missing (spaces) when either deductible, A3/21/125 Entity Code PRP coinsurance, prior pay, est amt due, est responsibility are present N50E Payer Name PAYER A, B OR C HAS INVALID ALPHA PREFIX A3/33 N51A Blue Cross Provider Number Invalid provider number A3/135 N52A Information Release Not = Y, N, R or space A3/359 Certification Indicator N53A Benefit Assignment Not = Y, N or space A3/360 Certification Indicator N54A Prior Payments Not numeric A3/402/672 N54B Prior Payments Less than zero: Prior Payer A,B,C A3/402/672 N55A Estimate Amount Due Not numeric A3/402/565 N55B Estimate Amount Due Less than zero A3/402/565 N56A Medicare Provider No HMO Claim and spaces A3/153 Entity Code 85 N58A Insured s Name First A Contains spaces or a leading blank A3/125 N58B Insured s Name Last A Contains spaces or a leading blank A3/125 N59A Patient Relationship to Insured Not numeric or zeros A3/156 N60A Line of Business A Payer A = 364 lob is not numeric A3/164 Entity Code PRP N60B Medicare HIC Number There is a space within the Med HIC Number A3/164 N60C Line of Business A Invalid A3/164 Entity Code PRP N60E Medicare HIC No Invalid HIC number, too long A3/164 N60F Eligibility Error Invalid member Id A3/164

8 N60G Contract No Contract number is all zeros A3/29 N60H Eligibility Error No coverage found for date of service A3/91 N60I Eligibility Error Member is on a group that all claims should be A3/114 Entity Code 36 rejected (City of Scranton) N61A Insured Group Numb. A, B or C Contains invalid characters A3/163 Entity Code IL N62A Insured Group Number A Payer A group number contains a space A3/163 Entity Code IL N62B Insured Group Number B Payer B group number contains a space A3/163 Entity Code IL N62C Insured Group Number C Payer C group number contains a space A3/163 Entity Code IL N63A Treatment Auth Code 1 Contains invalid characters A3/252 N63B Treatment Auth Code 2 Contains invalid characters A3/252 N66A Employer Location 1 State Not spaces, invalid state A3/167 Entity Code IL N66B Employer Location 2 State Not spaces, invalid state A3/167 Entity Code IL N67A Principal Diagnosis Code Equal to spaces or zeros A3/254 N67B Principal Diagnosis Code ICD-9 diagnosis code must be either numeric or A3/254 begin with V N67C Principal Diagnosis Code Not found on file A3/254 N67D Principal Diagnosis Code Diagnosis code not valid for date of claim A3/254 N67E Principal Diagnosis Code Title Diagnosis not valid on principal diagnosis code A3/254 N67F Principal Diagnosis Code Qualifier not Valid for Principle Diag Code A3/745/254 New ICD-10 Error N70A Eligibility Error From Eligibility Error 1011 Junior Jumbo Alpha- A8/33/116 Prefix Claims should be processed at Highmark N70B Eligibility Error From Eligibility Error 1012 Host or FEP Claims A8/116 should be processed at Highmark N70C Eligibility Error From Eligibility Error 1013 HMK Alpha-Prefix A8/116 Claims should be processed at Highmark N76B Admitting Diagnosis Code Not Found on File A3/232 N76C Admitting Diagnosis Code Title Diag not Valid on Admitting Diag Code A3/232 N76D Admitting Diagnosis Code Diag Code Not valid for Date of Claim A3/232 N76F Admitting Diagnosis Code Qualifier Not Valid for Admit Diag Code A3/745/232 New ICD-10 Error N7AA Other Diagnosis Code 1 No previous code A3/255 N7AC Other Diagnosis Code 1 Not found on File A3/255 N7AD Other Diagnosis Code 1 2 nd diagnosis code not valid for date of claim A3/255 N7AE Other Diagnosis Code 1 Title diagnosis code not allowed A3/255 N7AF Other Diagnosis Code 1 Qualifier Not valid for 2 nd Diag Code A3/745/255 New ICD-10 Error N7BA Other Diagnosis Code 2 No previous code A3/255 N7BC Other Diagnosis Code 2 Not found on File A3/255 N7BD Other Diagnosis Code 2 3rd diagnosis code not valid for date of claim A3/255 N7BE Other Diagnosis Code 2 Title diagnosis code not allowed A3/255 N7BF Other Diagnosis Code 2 Qualifier not valid for 3 rd Diag Code A3/745/255 New ICD-10 Error N7CA Other Diagnosis Code 3 No previous code A3/255 N7CC Other Diagnosis Code 3 Not found on File A3/255 N7CD Other Diagnosis Code 3 4th diagnosis code not valid for date of claim A3/255 N7CE Other Diagnosis Code 3 Title diagnosis code not allowed A3/255 N7CF Other Diagnosis Code 3 Qualifier not valid for 4 th Diag Code A3/745/255 New ICD-10 Error N7DA Other Diagnosis Code 4 No previous code A3/255 N7DC Other Diagnosis Code 4 Not found on File A3/255 N7DD Other Diagnosis Code 4 5th diagnosis code not valid for date of claim A3/255 N7DE Other Diagnosis Code 4 Title diagnosis code not allowed A3/255 N7DF Other Diagnosis Code 4 Qualifier not valid for 5 th Diag Code A3/745/255 New ICD-10 Error N7EA Other Diagnosis Code 5 No previous code A3/255 N7EC Other Diagnosis Code 5 Not found on File A3/255 N7ED Other Diagnosis Code 5 6th diagnosis code not valid for date of claim A3/255 N7EE Other Diagnosis Code 5 Title diagnosis code not allowed A3/255 N7EF Other Diagnosis Code 5 Qualifier Not valid for 6 th Diag Code A3/745/255 New ICD-10 Error N7FA Other Diagnosis Code 6 No previous code A3/255 N7FC Other Diagnosis Code 6 Not found on File A3/255 N7FD Other Diagnosis Code 6 7th diagnosis code not valid for date of claim A3/255 N7FE Other Diagnosis Code 6 Title diagnosis code not allowed A3/255 N7FF Other Diagnosis Code 6 Qualifier not valid for 7 th Diag Code A3/745/255 New ICD-10 Error N7GA Other Diagnosis Code 7 No previous code A3/255 N7GC Other Diagnosis Code 7 Not found on File A3/255 N7GD Other Diagnosis Code 7 8th diagnosis code not valid for date of claim A3/255 N7GE Other Diagnosis Code 7 Title diagnosis code not allowed A3/255 N7GF Other Diagnosis Code 7 Qualifier not Valid for 8 th Diag Code A3/745/255 New ICD-10 Error N7HA Other Diagnosis Code 8 No previous code A3/255

9 N7HC Other Diagnosis Code 8 Not found on File A3/255 N7HD Other Diagnosis Code 8 9th diagnosis code not valid for date of claim A3/255 N7HE Other Diagnosis Code 8 Title diagnosis code not allowed A3/255 N7HF Other Diagnosis Code 8 Qualifier not valid for 9 th Diag Code A3/745/255 New ICD-10 Error N7IA Other Diagnosis Code 9 No previous code A3/255 N7IC Other Diagnosis Code 9 Not found on File A3/255 N7ID Other Diagnosis Code 9 10th diagnosis code not valid for date of claim A3/255 N7IE Other Diagnosis Code 9 Title diagnosis code not allowed A3/255 N7IF Other Diagnosis Code 9 Qualifier not valid for 10 th Diagnosis Code A3/745/255 New ICD-10 Error N7JA Other Diagnosis Code 10 No previous code A3/255 N7JC Other Diagnosis Code 10 Not found on File A3/255 N7JD Other Diagnosis Code 10 11th diagnosis code not valid for date of claim A3/255 N7JE Other Diagnosis Code 10 Title diagnosis code not allowed A3/255 N7JF Other Diagnosis Code 10 Qualifier not valid for 11 th Diagnosis Code A3/745/255 New ICD-10 Error N7KA Other Diagnosis Code 11 No previous code A3/255 N7KC Other Diagnosis Code 11 Not found on File A3/255 N7KD Other Diagnosis Code 11 12th diagnosis code not valid for date of claim A3/255 N7KE Other Diagnosis Code 11 Title diagnosis code not allowed A3/255 N7KF Other Diagnosis Code 11 Qualifier not valid for 12 th Diagnosis Code A3/745/255 New ICD-10 Error N7LA Other Diagnosis Code 12 No previous code A3/255 N7LC Other Diagnosis Code 12 Not found on File A3/255 N7LD Other Diagnosis Code 12 13th diagnosis code not valid for date of claim A3/255 N7LE Other Diagnosis Code 12 Title diagnosis code not allowed A3/255 N7LF Other Diagnosis Code 12 Qualifier not valid for 13 th Diagnosis Code A3/745/255 New ICD-10 Error N7MA Other Diagnosis Code 13 No previous code A3/255 N7MC Other Diagnosis Code 13 Not found on File A3/255 N7MD Other Diagnosis Code 13 14th diagnosis code not valid for date of claim A3/255 N7ME Other Diagnosis Code 13 Title diagnosis code not allowed A3/255 N7MF Other Diagnosis Code 13 Qualifier not valid for 14 th Diagnosis Code A3/745/255 New ICD-10 Error N7NA Other Diagnosis Code 14 No previous code A3/255 N7NC Other Diagnosis Code 14 Not found on File A3/255 N7ND Other Diagnosis Code 14 15th diagnosis code not valid for date of claim A3/255 N7NE Other Diagnosis Code 14 Title diagnosis code not allowed A3/255 N7NF Other Diagnosis Code 14 Qualifier not valid for 15 th Diagnosis Code A3/745/255 New ICD-10 Error N7OA Other Diagnosis Code 15 No previous code A3/255 N7OC Other Diagnosis Code 15 Not found on File A3/255 N7OD Other Diagnosis Code 15 16h diagnosis code not valid for date of claim A3/255 N7OE Other Diagnosis Code 15 Title diagnosis code not allowed A3/255 N7OF Other Diagnosis Code 15 Qualifier not valid for 16 th Diagnosis Code A3/745/255 New ICD-10 Error N7PA Other Diagnosis Code 16 No previous code A3/255 N7PC Other Diagnosis Code 16 Not found on File A3/255 N7PD Other Diagnosis Code 16 17th diagnosis code not valid for date of claim A3/255 N7PE Other Diagnosis Code 16 Title diagnosis code not allowed A3/255 N7PF Other Diagnosis Code 16 Qualifier not valid for 17 th Diagnosis Code A3/745/255 New ICD-10 Error N80A Principal Procedure Code Procedure code not found on file or procedure code A3/465 not valid for date of claim N80B Principal Procedure Date Equal to zeros or not numeric A3/486 N80C Principal Procedure Date Date not in Effective and Term Range A3/486 N80D Principal Procedure Date Bad date A3/486 N80E Principal Procedure Code Cannot be title code A3/465 N80F Principal Procedure Code Procedure code not valid for date of claim A3/465 N80G Principal Procedure Code Qualifier not valid for Princ Proc Code A3/745/465 New ICD-10 Error N80N Principal Procedure Code Principal procedure code on outpatient claim A3/465 N82A Attending Physician ID Missing/invalid A3/153 Entity Code 71 N82B Attending Physician Last Name Missing/Invalid A3/504 Entity Code 71 N82C Attending Physician First Name Missing/Invalid A3/505 Entity Code 71 N82D Attending Phys Middle Initial Missing/Invalid A3/514 Entity Code 71 N83A Other Physician Id/Name Missing/Invalid A3/153 Entity Code 73 N83B Other Physician Last First position cannot be a space, or name cannot be A3/504 Entity Code 73 numeric N83C Other Physician First First position cannot be a space, or name cannot be A3/505 Entity Code 73 numeric N83D Other Physician Middle Initial Must be alphabetic A3/514 Entity Code 73 N84A Remarks Line 1 Missing (spaces) and Tran-To-Provider= or Required with Revenue code 279 A3/21

10 N86A Date Bill Submitted Invalid Date A3/21 N89A Admission Notification Number Admission Notification Number Missing A3/252 N89B Admission Notification Number Admission Notification Number Does Not Match A3/252 N89C Admission Notification Number Date of Service on Admission Notification Number A3/674 not within 3 Days of Admission Date N8AA Other Procedure Code (1) Procedure code 1 not found on file A3/490 N8AB Other Procedure Date (1) Zeros or not numeric with a Prin-Proc-Cd A3/492 N8AC Other Procedure Date (1) Not zero and no Prin-Proc-Cd A3/492 N8AD Other Procedure Date (1) Bad Date A3/492 N8AE Other Procedure Date (1) title code not valid for other proc code A3/492 N8AF Other Procedure Code (1) Procedure Code 1 not valid for date of claim A3/490 N8AG Other Procedure Code (1) Qualifier Not Valid for Other Proc Code A3/745/490 New ICD-10 Error N8BA Other Procedure Code (2) Procedure Code 2 not found on file A3/490 N8BB Other Procedure Date (2) Zeros or not numeric with a Prin-Proc-Cd A3/492 N8BC Other Procedure Date (2) Not zero and no Prin-Proc-Cd A3/492 N8BD Other Procedure Date (2) Bad Date A3/492 N8BE Other Procedure Date (2) title code not valid for other proc code A3/492 N8BF Other Procedure Code (2) Proc Code 2 not valid for date of claim A3/490 N8BG Other Procedure Code (2) Qualifier not Valid for Other Proc Code A3/745/490 New ICD-10 Error N8CA Other Procedure Code (3) Procedure code 3 not found on file A3/490 N8CB Other Procedure Date (3) Zeros or not numeric with a Prin-Proc-Cd A3/492 N8CC Other Procedure Date (3) Not zero and no Prin-Proc-Cd A3/492 N8CD Other Procedure Date (3) Bad Date A3/492 N8CE Other Procedure Date (3) Title Code not Valid for Other Proc Code A3/492 N8CF Other Procedure Code (3) Proc Code 3 not valid for date of claim A3/492 N8CG Other Procedure Code(3) Qualifier not valid for other proc code A3/745/490 New ICD-10 Error N8DA Other Procedure Code (4) Procedure code 4 not found on file A3/490 N8DB Other Procedure Date (4) Zeros or not numeric with a Prin-Proc-Cd A3/492 N8DC Other Procedure Date (4) Not zero and no Prin-Proc-Cd A3/492 N8DD Other Procedure Date (4) Bad Date A3/492 N8DE Other Procedure Date (4) title code not valid for other proc code A3/492 N8DF Other Procedure Code (4) Proc code 4 not valid for date of claim A3/490 N8DG Other Procedure Code (4) Qualifier not valid for other proc code A3/745/490 New ICD-10 Error N8EA Other Procedure Code (5) Procedure code 5 not found on file A3/490 N8EB Other Procedure Date (5) Zeros or not numeric with a Prin-Proc-Cd A3/492 N8EC Other Procedure Date (5) Not zero and no Prin-Proc-Cd A3/492 N8ED Other Procedure Date(5) Bad Date A3/492 N8EE Other Procedure Date (5) Bad date - title code not valid for other proc code A3/492 N8EF Other Procedure Code (5) Proc code 5 not valid for date of claim A3/490 N8EG Other Procedure Code(5) Qualifier not valid for other proc code A3/745/490 New ICD-10 Error N90A National Provider Number Missing A3/129 N90B Federal Tax No Invalid NPI/Tax Number Combo A3/128 N91A Provider Taxonomy Code Invalid or missing A3/145 Entity Code 85 N99A DRG Not valid DRG code A3/256