News

May 18, 2007

EDI Midwest Warning Edits Effective 05/20/2007

As NPI is implemented, additional editing is needed to transfer the editing currently used for legacy provider numbers to the new NPI numbers. The edits below reflect the additional edits created to fill this need. While the edit numbers are new to users, the reason for the edits is not and trading partners should be use to this kind of editing.

New NPI Edits were created for EDI Midwest (commercial claims).  The following edits will result in warnings beginning 5/20/07.  These claims do not need to be resubmitted and will be sent to the clearinghouse.

C376	Billing NPI not tied to TP Number
	Logic: The NPI in the 2010AA NM109 is not found on the ASK Trading Partner file.
C377	Billing NPI not on payer provider file
	Logic: The NPI in the 2010AA NM109 is not setup for EDI Midwest.
C378	Billing NPI not setup for this transaction
	Logic: The NPI in the 2010AA NM109 is not setup for this transaction type.
C379	T/P Indicator invalid for Billing NPI
	Logic: The NPI in the 2010AA NM109 is not setup for the submitted Test/Production indicator.