status category identifier code status category code...

Status

Code Status Code Description

Status

Category

Code Status Category Code Description

Entity

Identifier

Code CA Error Code Description

Entity's id number. Note: This

code requires use of an Entity

Code. A6

Acknowledgement/Rejected for Missing

Information - The claim/encounter is

missing the information specified in the

Status details and has been rejected. 82

PROVIDER ID NOT FOUND /

Code. A6

REQUESTED FACILITY

PROVIDER NOT FOUND OR

Code. A7

Acknowledgement/Rejected for Invalid

Information - The claim/encounter has

invalid information as specified in the

Status details and has been rejected.

INVALID P/H CODE IN TYPE

010 RECORD.

251 Total anesthesia minutes. A7

TOTAL TIME CANNOT EXCEED

Code. A6

MEMBER ID NOT FOUND /

Entity's health industry id

number. Note: This code

requires use of an Entity Code. A6

HPCODE NOT FOUND OR

EMPTY FOR THIS MEMBER

Entity's date of birth. Note: This

Code. A7

MEMBER INFO (DOB) INVALID

(OR) EMPTY

Identifier Qualifier Note: At

least one other status code is

required to identify the specific

identifier qualifier in error. A6

QUAL CODE NOT FOUND FOR

PROVIDER ID.

Code. A6

OTHER PROVIDER ID NOT

FOUND.

Entity's National Provider

Identifier (NPI). Note: This code

REFERRING PROVIDER NPI ID /

OUTSIDE ID NOT FOUND FOR

REFERRING QUAL CODE NPI.

255 Diagnosis code. A6

DIAGNOSIS CODE NOT FOUND

OR EMPTY

Entity is not selected primary

care provider. Note: This code

VENDOR IS NOT CONFIGURED

FOR THE PROVIDER

Code. A6

VENDOR ID NOT FOUND /

538 Claim or Encounter Identifier A7

Status details and has been rejected. INVALID PCP ENCOUNTER

Status details and has been rejected. INVALID # ENCOUNTERS (Y)

Status details and has been rejected. INVALID # ENCOUNTERS (N)

554 Date Claim Paid A7

Status details and has been rejected. INVALID DATE PAID

Patient eligibility not found with

entity. Note: This code requires

use of an Entity Code. A7

Status details and has been rejected. INVALID BENEFIT OPTION

Code. A7

INVALID PAYEE( MUST BE

VENDOR, MEMBER OR

SUBSCRIBER )

249 Place of service. A6

PLACE OF SERVICE CODE NOT

742 Payer Responsibility Sequence Number CodeA7

INVALID PAYER

RESPONSIBILITY.

Code. A7

Status details and has been rejected. INVALID FACILITY CODE.

249 Place of service. A6

PLACE OF SERVICE CODE NOT

Code. A7

Status details and has been rejected. DN

INVALID REFERRING

PROVIDER ID

659 Unit or Basis for Measurement CodeA7

AUTHORIZED # OF UNITS

CANNOT BE NEGATIVE -

USING 0

Code. A6

Status details and has been rejected. OUTCOME CODE NOT FOUND.

48 Referral/authorization. A6

AUTHORIZATION NUMBER

NOT FOUND.

Code. A7

ADMITTING PROVIDER DOES

NOT EXIST

535 Claim Frequency Code A7

Status details and has been rejected. INVALID BILL TYPE

Code. A7

INVALID ATTENDING

PROVIDER

231 Hospital admission type. A7

INVALID CLAIM ADMITTANCE

229 Hospital admission source. A7

INVALID ADMITTANCE

SOURCE

460 NUBC Condition Code(s) A7

Status details and has been rejected. INVALID CONDITION CODE 1

189 Facility admission date A7

Status details and has been rejected. INVALID ADMISSION DATE

Facility admission through

discharge dates A7

ADMISSION AND DISCHARGE

DATE CONFLICT

230 Hospital admission hour. A7

Status details and has been rejected. INVALID ADMISSION HOUR

233 Hospital discharge hour. A7

Status details and has been rejected. INVALID DISCHARGE HOUR

456 Covered Day(s) A7

INVALID HOSPITAL DAYS –

COVERED

457 Non-Covered Day(s) A7

NON-COVERED

458 Coinsurance Day(s) A7

INVALID HOSPITAL DAYS – CO-

INSURANCE

459 Lifetime Reserve Day(s) A7

LIFETIME RESERVE

Code. A7

INVALID CONSULTING

PROVIDER 1

Code. A7

INVALID CONSULTING

PROVIDER 2

232 Admitting diagnosis. A7

INVALID ADMISSION

DIAGNOSIS

509 External Cause of Injury Code (E-code).A7

Status details and has been rejected. INVALID E-CODE

Benefits Assignment

Certification Indicator. A7

INVALID OR MISSING

ASSIGNMENT OF BENEFIT –

PRIMARY

Benefits Assignment

INVALID ASSIGNMENT OF

BENEFIT – SECONDARY

Benefits Assignment

INVALID ASSIGNMENT OF

BENEFIT – TERTIARY

Amount entity has paid. Note:

This code requires use of an

Entity Code. A7

INVALID PRIOR PAYMENT –

PRIMARY

Entity Code. A7

SECONDARY

Entity Code. A7

TERTIARY

Entity Code. A7

DUE FROM PATIENT

565 Estimated Claim Due Amount A7

INVALID EST. AMOUNT DUE –

PRIMARY

SECONDARY

TERTIARY

DUE FROM PATIENT

655 Total Medicare Paid Amount A7

Status details and has been rejected. MEDICARE PAID AMOUNT

591 Medicare Paid at 100% Amount A7

MEDICARE 100% PAID

AMOUNT

592 Medicare Paid at 80% Amount A7

MEDICARE 80% PAID

AMOUNT

Paid From Part A Medicare

Trust Fund Amount A7

MEDICARE A TRUST FUND

PAID AMOUNT

Paid From Part B Medicare

Trust Fund Amount A7

MEDICARE B TRUST FUND

PAID AMOUNT

596 Non-covered Charge Amount A7

COB TOTAL NON-COVERED

AMOUNT

585 Denied Charge or Non-covered ChargeA7

Status details and has been rejected. COB TOTAL DENIED AMOUNT

285 Vouchers/explanation of benefits (EOB).A7

Status details and has been rejected. EOB INDICATOR

INVALID EXTERNAL CAUSE OF

INJURY CODE -B .

INJURY CODE -C .

ADMITTING PROVIDER NPI ID

/ OUTSIDE ID NOT FOUND

FOR ADMITTING PROVIDER

NPI QUAL CODE.

CONSULTING ID 1 NPI ID /

CONSULTING ID 1 NPI QUAL

CONSULTING ID 2 NPI ID /

CONSULTING ID 2 NPI QUAL

ATTENDING NPI ID / OUTSIDE

ID NOT FOUND FOR

ATTENDING NPI QUAL CODE.

Other Procedure Code for

Service(s) Rendered A6

OTHER PROCEDURE CODE

[%%] AND OTHER

PROCEDURES DATE [%%] ARE

REQUIRED

Code. A7

INVALID SERVICE FACILITY

LOCATION INFORMATION(32)-

Code. A7

INVALID BILLING PROVIDER

INFORMATION

Related Causes Code (Accident,

auto accident, employment) A7

INVALID PATIENT CONDITION -

EMPLOYMENT

INVALID PATIENT CONDITION

– AUTO ACCIDENT

INVALID PATIENT CONDITION

– OTHER ACCIDENT

Entity's address. Note: This

Code. A7

Status details and has been rejected. INVALID PLACE

749 Date of Injury/Illness A7

Status details and has been rejected. INVALID DATE OF CURRENT

648 Similar Illness or Symptom Date A7

INVALID SAMESIMILAR

ILLNESS

195 Unable to work dates/Disability Dates.A7

INVALID UNABLE TO WORK

FROMDATE

195 Unable to work dates/Disability Dates.A7

INVALID UNABLE TO WORK

TODATE

Date(s) of most recent

hospitalization related to

service A7

INVALID HOSPITALIZED FROM

Date(s) of most recent

hospitalization related to

service A7

INVALID HOSPITALIZED TO

179 Outside lab charges. A7

Status details and has been rejected. INVALID OUTSIDE LAB – YES

589 Provider Accept Assignment CodeA7

INVALID ACCEPT

ASSIGNMENT – YES

428 Reason for transport by ambulanceA7

INVALID TRANSPORT REASON

Ambulance Drop-off State or

Province Code A7

INVALID AMBULANCE DROP-

OFF ADDRESS LINE1

Ambulance Drop-off State or

Province Code A7

INVALID AMBULANCE DROP-

OFF CITY NAME

Ambulance Pick-up State or

Province Code A7

INVALID AMBULANCE PICK-UP

ADDRESS LINE1

Ambulance Pick-up State or

Province Code A7

INVALID AMBULANCE PICK-UP

CITY NAME

188 Statement from-through dates. A7

INVALID OR MISSING

STATEMENT FROM DATE.

INVALID OR MISSING

STATEMENT TO DATE.

Entity's relationship to patient.

Note: This code requires use of

an Entity Code. A7

INVALID PATIENT’S

RELATIONSHIP TO INSURED –

PRIMARY.

an Entity Code. A7

INVALID PATIENT’S

SECONDARY.

an Entity Code. A7

INVALID PATIENT’S

TERTIARY.

Entity's employment status.

an Entity Code. A7

INVALID EMPLOYMENT

STATUS – PRIMARY.

an Entity Code. A7

INVALID EMPLOYMENT

STATUS – SECONDARY.

an Entity Code. A7

INVALID EMPLOYMENT

STATUS – TERTIARY.

Code. A7

INVALID OTHER PROVIDER ID

– PRIMARY – EZ-CAP ID

Code. A7

– SECONDARY – EZ-CAP ID

Code. A7

– TERTIARY – EZ-CAP ID

Code. A7

INVALID OPERATING ID – EZ-

CAP ID

Code. A7

Status details and has been rejected. INVALID OTHER ID – EZ-CAP ID

673 Patient Reason for Visit A7

INVALID PATIENT’S REASON

FOR VISIT – A -VALIDATE

AGAINST DIAG TABLE FOR

VALID CODE

FOR VISIT – B -VALIDATE

VALID CODE-

FOR VISIT – C -VALIDATE

VALID CODE

728 Accident state A7

Status details and has been rejected. INVALID ACCIDENT STATE

OPERATING PROVIDER NPI ID/

QUAL CODE.

OTHER PROVIDER ID /

OTHER PROVIDER QUAL

OTHER PROVIDER2 NPI ID/

OTHER PROVIDER2 QUAL

OTHER PROVIDER ID 2 /

OTHER PROVIDER QUAL

535 Claim Frequency Code A7

Status details and has been rejected. INVALID FREQUENCY CODE

Home Infusion EDI Coalition

(HEIC) Product/Service Code A7

Status details and has been rejected. INVALID SERVICE CODE

Procedure Code Modifier(s) for

Status details and has been rejected. INVALID MODIFIER CODE 1

583 Line Item Charge Amount A7

Status details and has been rejected. NOT A VALID BILLED DECIMAL

476 Missing or invalid units of serviceA7

Status details and has been rejected. QUANTITY IS NOT VALID

521 Adjustment Reason Code A7

Status details and has been rejected. INVALID ADJUSTMENT CODE

521 Adjustment Reason Code A6

Status details and has been rejected. MISSING ADJUSTMENT CODE

564 EPSDT Indicator A7

Status details and has been rejected. INVALID # EPSDT (Y/N)

216 Drug information. A7

Status details and has been rejected. INVALID NDC UNIT PRICE

Status details and has been rejected. INVALID NDC QUANTITY

Status details and has been rejected. INVALID NDC CODE

98 Charges applied to deductible. A7

Status details and has been rejected. INVALID DEDUCTIBLE

705 Repriced Allowed Amount A7

Status details and has been rejected. INVALID ALLOWED

477 Diagnosis code pointer is missing or invalidA7

INVALID DIAGNOSIS CODE

POINTER 2

POINTER 3

POINTER 4

TODATE/STOPTIME MUST BE

GREATER THAN OR EQUAL TO

FROMDATE/STARTTIME

Entity's specialty/taxonomy

code. Note: This code requires

use of an Entity Code. A7

Status details and has been rejected. INVALID OR MISSING TAXONOMY CODE

Code. A7

INVALID RENDERING

PROVIDER ID

RENDERING PROVIDER ID /

RENDERING PROVIDER QUAL

POINTER 1

Status details and has been rejected. INVALID DIAGNOSIS REFERENCE NUMBER

INVALID ANESTHESIA START

INVALID ANESTHESIA STOP

187 Date(s) of service. A7

Status details and has been rejected. INVALID FROM DATE

187 Date(s) of service. A7

Status details and has been rejected. INVALID TO DATE

455 Revenue code for services rendered.A7

INVALID HOSPITAL SERVICE

471 Were services related to an emergency?A7

NOT A VALID EMERGENCY

INVALID OR MISSING

PROCEDURE CODE 1.

INVALID OR MISSING

PROCEDURE CODE 2.

INVALID OR MISSING

PROCEDURE CODE 3.

INVALID OR MISSING

PROCEDURE CODE 4.

INVALID OR MISSING

PROCEDURE CODE 5.

INVALID OR MISSING

PROCEDURE CODE 6.

INVALID OR MISSING

PROCEDURE CODE 7.

INVALID OR MISSING

PROCEDURE CODE 8.

INVALID OR MISSING

PROCEDURE CODE 9.

INVALID OR MISSING

PROCEDURE CODE 10.

INVALID OR MISSING

PROCEDURE CODE 11.

INVALID OR MISSING

PROCEDURE CODE 12.

INVALID OR MISSING

PROCEDURE CODE 13.

492 Other Procedure Date A7

INVALID OR MISSING

PROCEDURE DATE 1.

INVALID OR MISSING

PROCEDURE DATE 2.

INVALID OR MISSING

PROCEDURE DATE 3.

INVALID OR MISSING

PROCEDURE DATE 4.

INVALID OR MISSING

PROCEDURE DATE 5.

INVALID OR MISSING

PROCEDURE DATE 6.

INVALID OR MISSING

PROCEDURE DATE 7.

INVALID OR MISSING

PROCEDURE DATE 8.

INVALID OR MISSING

PROCEDURE DATE 9.

INVALID OR MISSING

PROCEDURE DATE 10.

INVALID OR MISSING

PROCEDURE DATE 11.

INVALID OR MISSING

PROCEDURE DATE 12.

INVALID OR MISSING

PROCEDURE DATE 13.

719 NUBC Occurrence Code(s) A7

INVALID OR MISSING

OCCURRENCE CODE 1.

INVALID OR MISSING

OCCURRENCE CODE 2.

INVALID OR MISSING

OCCURRENCE CODE 3.

INVALID OR MISSING

OCCURRENCE CODE 4.

INVALID OR MISSING

OCCURRENCE CODE 5.

INVALID OR MISSING

OCCURRENCE CODE 6.

INVALID OR MISSING

OCCURRENCE CODE 7.

INVALID OR MISSING

OCCURRENCE CODE 8.

INVALID OR MISSING

OCCURRENCE CODE 9.

INVALID OR MISSING

OCCURRENCE CODE 10.

INVALID OR MISSING

OCCURRENCE CODE 11.

INVALID OR MISSING

OCCURRENCE CODE 12.

720 NUBC Occurrence Code Date(s) A7

INVALID OR MISSING

OCCURRENCE DATE 1.

INVALID OR MISSING

OCCURRENCE DATE 2.

INVALID OR MISSING

OCCURRENCE DATE 3.

INVALID OR MISSING

OCCURRENCE DATE 4.

INVALID OR MISSING

OCCURRENCE DATE 5.

INVALID OR MISSING

OCCURRENCE DATE 6.

INVALID OR MISSING

OCCURRENCE DATE 7.

INVALID OR MISSING

OCCURRENCE DATE 8.

INVALID OR MISSING

OCCURRENCE DATE 9.

INVALID OR MISSING

OCCURRENCE DATE 10.

INVALID OR MISSING

OCCURRENCE DATE 11.

INVALID OR MISSING

OCCURRENCE DATE 12.

721 NUBC Occurrence Span Code(s) A7

INVALID OR MISSING

OCCURRENCE SPAN CODE 1.

INVALID OR MISSING

722 NUBC Occurrence Span Code Date(s)A7

INVALID OR MISSING

OCCURRENCE SPAN DATE

FROM 1.

INVALID OR MISSING

FROM 2.

INVALID OR MISSING

FROM 3.

INVALID OR MISSING

FROM 4.

INVALID OR MISSING

FROM 5.

INVALID OR MISSING

FROM 6.

INVALID OR MISSING

FROM 7.

INVALID OR MISSING

FROM 8.

INVALID OR MISSING

FROM 9.

INVALID OR MISSING

FROM 10.

INVALID OR MISSING

FROM 11.

INVALID OR MISSING

FROM 12.

INVALID OR MISSING

OCCURRENCE SPAN DATE TO

INVALID OR MISSING

725 NUBC Value Code(s) A7

INVALID OR MISSING VALUE

CODE 1.

CODE 2.

CODE 3.

CODE 4.

CODE 5.

CODE 6.

CODE 7.

CODE 8.

CODE 9.

CODE 10.

CODE 11.

CODE 12.

726 NUBC Value Code Amount(s) A7

AMOUNT 1.

AMOUNT 2.

AMOUNT 3.

AMOUNT 4.

AMOUNT 5.

AMOUNT 6.

AMOUNT 7.

AMOUNT 8.

AMOUNT 9.

AMOUNT 10.

AMOUNT 11.

AMOUNT 12.

Present on Admission Indicator

for reported diagnosis code(s). A6

DIAGNOSIS POA CODE NOT

FOUND OR EMPTY

INVALID ADMISSION

DIAGNOSIS POA

Status details and has been rejected. INVALID E-CODE POA

INJURY CODE - B POA

INJURY CODE - C POA

FOR VISIT – A POA - VALIDATE

AGAINST COMMON CODES

TABLE FOR VALID CODE

FOR VISIT – B POA - VALIDATE

FOR VISIT – C POA - VALIDATE

THE RENDERING PROVIDER

NPI IS NOT CONFIGURED FOR

THE RENDERING PROVIDER

INVALID OR MISSING TAXONOMY CODE

INVALID DIAGNOSIS REFERENCE NUMBER

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