Electronic Claim Errors
A knowledge base of common electronic claim errors and possible solutions.
- Unknown/Invalid Payer
- Rendering Taxonomy code Invalid
- 508 - ICD9 Usage: At least one other status code is required to identify the related procedure code or diagnosis code.
- Property and Casualty Claim Number (REF*Y4, Loop 2010CA ) is required. This can also be sent in as the Prior Authorization Number.
- The member number cannot be found. Please verify using the ID card and resubmit electronically including the alpha prefix. For assistance, call the 800 number on the card or BCBSF (800) 727-2227.
- MODIFIER 0 IS INVALID
- REJECTED AT CLEARINGHOUSE SUBSCRIBER PRIMARY ID# MUST BE BETWEEN 9 AND 11 CHARACTERS.
- 718 - Claim/service not submitted within the required timeframe (timely filing).
- Entitys id number. :
- Entity not approved as an electronic submitter.
- Payer rejected for eligibility not found for the Subscriber. This could indicate no coverage for the submitted Services Dates or incorrect demographic information or invalid payer mapping.
- DIAGNOSIS CODE: INVALID; THE NUMBER OF DIAGNOSIS CODES ON THE CLAIM MUST NOT EXCEED ALLOWABLE NUMBER FOR PAYER
- 126 - Rejected Entity not found. Rejected Entitys address.
- MISSINGINVALID RENDERING PROVIDER ADDRESS
- ACK/REJECT RELATIONAL - CLAIM SUBMITTED TO INCORRECT PAYER. - PAYER
- 90 - Entity not eligible for medical benefits for submitted dates of service. Usage: This code requires use of an Entity Code.
- ACKNOWLEDGEMENTRETURNED AS UNPROCESSABLE CLAIM
- Entitys tax id. (Rendering Provider)
- 700 - ICD10. Usage: At least one other status code is required to identify the related procedure code or diagnosis code.
- PROC CODE W MULTI UNITS INVALIDDATE OF SERV
- 495 - Requests for re-adjudication must reference the newly assigned payer claim control number for this previously adjusted claim. Correct the payer claim control number and re-submit.
- SUBSCRIBERMEMBER ID NOT FOUND
- MISSINGINVALID BILLING
- Subscriber and policy numbercontract number not found. (Payer)
- 171 - Other insurance coverage information (health, liability, auto, etc.).
- Invalid billing combination. Missing or invalid information. Subscriber and subscriber id not found.MSG EDIT FAILED - LOOP 2010BA - NM109 -
- 27 - Policy canceled.
- The Claim/Encounter has invalid information as specified in the Status details and has been rejected Status: Missing or invalid information Entity: Patient
- Value of element NM109 is incorrect. It should be different from value of element SBR03. Segment NM1 is defined in the guideline at position 0150.
- Entity not eligible for benefits for submitted dates of service. Note: This code requires use of an Entity Code.