Monday, August 11, 2008

Humana NPI claim exclusion edits

If your medical office is billing claims electronically to Humana CPID#2449 you will find that starting August 8th, 2008 they are scrubbing for new edits. If you get these edits you are using a invalid NPI or not actually sending the correct NPI information on your claims. Fix and rebill claims.

EDIT HU 0019C:INVALID BILLING PROVIDER NPI - IN LOOP 2010AA, NM108 MUST BE SENT AND MUST BE EQUAL TO XX

EDIT HU 0020C:INVALID PAY-TO PROVIDER NPI - IN LOOP 2010AB, NM108 MUST BE SENT AND MUST BE EQUAL TO XX

EDIT HU 0021C:INVALID CLAIM REFERRING PROV NPI - IN LOOP 2310A, WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0022C:INVALID CLAIM RENDERING PROVIDER NPI - IN LOOP 2010B(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0023C:INVALID CLAIM PURCHASED SERVICE NPI - IN LOOP 2310C(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0024C:INVALID CLAIM SERVICE FACILITY NPI - IN LOOP 2310D(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0025C:INVALID CLAIM SUPERVISING PROVIDER NPI - IN LOOP 2310E(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0028D:INVALID SRV LINE RENDERING PROVIDER NPI - IN LOOP 2420A(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0029D:INVALID SRV LINE PURCHASED SERVICE NPI - IN LOOP 2420B(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0030D:INVALID SRV LINE SERVICE FACILITY NPI - IN LOOP 2420C(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0031D:INVALID SRV LINE SUPERVISING PROVIDER NPI - IN LOOP 2420DC(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

EDIT HU 0032D:INVALID ORDERING PROVIDER NPI - IN LOOP 2420E(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX EDIT HU 0033D:INVALID SRV LINE REFERRING PROVIDER NPI - IN LOOP 2310C(PROF), WHEN NM108 IS SENT IT MUST BE EQUAL TO XX

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