|
Current Edit Code |
Message / Logic |
Legacy Only |
Dual Use |
NPI Only |
837P
837D |
B061 Legacy
Reject
B061A
NPI Warning |
Legacy Message - Rendering provider # not tied to Billing provider #.
NPI Message – Rendering NPI not tied to Billing NPI
Logic – The rendering provider number in 2310B-REF02 is a billing provider number, not a rendering provider number. |
B061B
Reject |
B061D Legacy Reject
B061C NPI
Warning |
B061E Reject |
837I |
B064 Legacy Reject |
Message - – Service facility information is required.
Logic - If 2310E-NM101 equal 'FA' and 2010BC-NM109 equal '47163' and (2010AA-NM108 equal ‘24’ or ‘34’, one (1) occurrence of this 2310E-REF segment with '1A' in 2310E-REF01 must be present. |
B064A Reject |
NA |
NA |
837I |
B222 Legacy Reject |
Message - One occurrence must be 1A for this payer.
Logic - If 2010BC-NM109 equals '47163' and 2010AA-NM108 equal ‘24’ or ‘34’ and : Does 2000B-SBR09 equal 'BL', if so one (1) occurrence of the 2010AA-REF segment contain the value of '1A' in 2010AA-REF01. |
B222A Reject |
NA |
NA |
837P
837D |
B257 Legacy Reject
B257A
NPI Warning |
Legacy Message - Group provider # cannot be used as Rendering provider#.
NPI Message – Group NPI can not be used as rendering NPI
Logic - The 2310B-REF02 Rendering Provider Number value is a Kansas Blue Shield Common Pay Provider Number value that may not be submitted as a Rendering Provider Number. |
B257B Reject |
B257D
Legacy
Reject
B257C
NPI Warning |
B257E
Reject |
837P
837D |
B258 Legacy Reject
Note: This is a new edit for Dental |
Message - Line Ren Prov # can not = Claim Ren Prov #
Logic – If 2010AA NM108 = '24' or '34', the 2420A-REF02 value cannot equal the 2310B-REF02 value. |
B258A Reject |
NA |
NA |
837P
837D |
B258
Legacy Reject |
Message - Line Ren Prov NPI can not = Claim Ren Prov NPI.
Logic – If 2010AA NM108 = 'XX', the 2420A-NM109 value cannot equal the 2310B-NM109 value. |
NA |
B258B Reject |
B258C Reject |
837P 837I 837D |
B274
Reject |
Message - Claim filtering indicator code must equal BL.
Logic - If 2010BB-NM109 (2010BC-NM109 for 837I) equals '47163' and 2010AA-NM108 equal ‘24’ or ‘34’ then the 2000B-SBR09 must equal 'BL'. |
B274A Reject |
NA |
NA |
837P 837I 837D |
B274
Reject |
Message - Claim filtering indicator code must equal BL.
Logic - If 2010BB-NM109 (2010BC-NM109 for 837I) equals '47163' and 2010AA-NM108 equal ‘XX’ then the 2000B-SBR09 must equal 'BL' |
NA |
274B Reject |
274B Reject |
837P
837D |
B275 Legacy Reject |
Message - Rendering provider number value is required.
Logic – If 2010AA-NM108 = '24' or '34', then 2310B-REF segment must have one occurrence of the value of '1B' in 2310B-REF01. |
B275A Reject |
NA |
NA |
837P
837D |
B275 Legacy Reject |
Message - Rendering provider number value is required.
Logic – If 2010AA-NM108 = '24' or '34' and 2420A NM101 = '82', then one occurrence of the value of '1B' in 2420A-REF01 is required. |
B275A Reject |
NA |
NA |
837P
837D |
B344 Legacy Reject |
Message - 2310B Rendering provider loop required with Billing provider.
Logic – If the provider number in 2010AA NM109 is a group provider number, then a rendering provider number is required in the 2310B NM109. |
B344A Reject |
B344B Warning |
B344C Reject |
837P
837D |
B351 Legacy Reject |
Message - One occurrence must be 1B for this payer.
Logic – If 2010BB-NM109 equals '47163' and 2010AA-NM108 equal ‘24’ or ‘34’, then one occurrence of the 2010AA-REF segment must contain the value of '1B' in 2010AA-REF01. |
B351A Reject |
NA |
NA |
837P 837I 837D |
B376
Warning |
Message - Billing NPI not tied to Trading partner.
Logic – The billing NPI located in the 2010AA NM109 must be setup for the Trading Partner submitting the claim. |
NA |
B376A Warning |
B376B Reject |
837P 837I 837D |
B377, B378,
B379
Warning |
Message - EDI Authentication failed.
Logic - Is the combination of (the ISA06 [Trading Partner] value and the 2010AA-NM109 [Billing Provider NPI] value using the proper Test/Production indicator and version? |
NA |
B379A Warning |
B379B Reject |
837P
837D |
NA |
Message - Rendering NPI value is required
Logic – If 2010AA NM108 = 'XX' and no legacy provider number is submitted in 2010AA REF01 and 2310B is present, then the 2310B must have 'XX'. |
NA |
NA |
B382 Reject |