Electronic Claim Errors
A knowledge base of common electronic claim errors and possible solutions.
- 772 - The greatest level of diagnosis code specificity is required.
- Submitter Number does not meet format restrictions for this payer. It must start with State Code WA followed by 5 or 6 numbers.
- 535 - Claim Frequency Code
- 24 - Entity not approved as an electronic submitter. Usage: This code requires use of an Entity Code.
- 634 - Remark Code
- 481 - Claim/submission format is invalid.
- 775 - Entity Type Qualifier (Person/Non-Person Entity). Usage: this code requires use of an entity code.
- Element NM103 (Name Last or Organization Name) is missing. This Element\'s user option is \'Must Use\'. Segment NM1 is defined in the guideline at position 0150
- 710 - Line Adjudication Information. Usage: At least one other status code is required to identify the data element in error.
- 95 - Requested additional information not received.
- 294 - Supporting documentation. Usage: At least one other status code is required to identify the supporting documentation.
- 33 - Subscriber and subscriber id not found.
- 677 - Entity not affiliated. Usage: This code requires use of an Entity Code.
- 480 - Entity's claim filing indicator. Usage: This code requires use of an Entity Code.
- 29 - Subscriber and policy number/contract number mismatched.
- 509 - External Cause of Injury Code
- 516 - Other Entity's Adjudication or Payment/Remittance Date. Usage: An Entity code is required to identify the Other Payer Entity, i.e. primary, secondary.
- 453 - Procedure Code Modifier(s) for Service(s) Rendered
- 21 - Missing or invalid information. Usage: At least one other status code is required to identify the missing or invalid information.
- 783 - Federal sequestration adjustment
- Referring prov first and last name must be in separate fields and both are required
- 521 - Adjustment Reason Code
- A3 143 P406 BILLING NPI REQUIRES RENDERING NPI
- Invalid Referring Physician NPI Format (Box 17B) - Fails Validation
- 564 - EPSDT Indicator
- 88 - Entity not eligible for benefits for submitted dates of service. Usage: This code requires use of an Entity Code.
- DTP03 NOT IN POLICY DATE RANGE
- 567 - Facility Code Qualifier
- Element NM104 is missing. It is recommended to be used when Referring Provider is a person (NM102=1). Segment NM1 is defined in the guideline at position 2500.
- A3 125 P147 REFERRING PROVIDER FIRST NAME IS MISSING OR INVALID - CLAIM