X12

Error Reason Codes

X12 External Code Source 977 8/24/2018 LAST UPDATED

The Error Reason codes are used to communicate the type of error reason.

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01	Inappropriate combination of service type code and service type code descriptor. Activation Date: 11/01/2017
02	Inappropriate service type code(s) Activation Date: 11/01/2017
03	The submitted procedure code(s) is not supported. Activation Date: 11/01/2017
04	Inquiries related to procedure codes are not supported. Activation Date: 11/01/2017
05	The submitted modifier code(s) is not supported. Activation Date: 11/01/2017
06	Inquiries related to modifier codes are not supported. Activation Date: 11/01/2017
07	The submitted diagnosis code(s) is not supported. Activation Date: 11/01/2017
08	Inquiries related to diagnosis codes are not supported. Activation Date: 11/01/2017
09	Duplicate ID Activation Date: 11/01/2017
10	Invalid subscriber or insured ID Activation Date: 11/01/2017
11	Missing subscriber or insured ID Activation Date: 11/01/2017
12	Missing subscriber or insured name Activation Date: 11/01/2017
13	Invalid date of death Activation Date: 11/01/2017
14	Missing date of death Activation Date: 11/01/2017
15	Missing provider name Activation Date: 11/01/2017
16	Invalid taxonomy Activation Date: 11/01/2017
17	Missing taxonomy Activation Date: 11/01/2017
18	Missing provider state Activation Date: 11/01/2017
19	Invalid referring provider ID Activation Date: 11/01/2017
20	Missing referring provider ID Activation Date: 11/01/2017
21	The request date(s) is not within the provider's plan enrollment period. Activation Date: 11/01/2017
22	The request date(s) precedes the date of birth. Activation Date: 11/01/2017
23	The date of death in our records precedes the request date(s). Activation Date: 11/01/2017
24	The request date(s) is not within the allowable inquiry period. Activation Date: 11/01/2017
25	The request date(s) is in the future. Activation Date: 11/01/2017
26	Invalid request date(s) Activation Date: 11/01/2017
27	Invalid patient ID Activation Date: 11/01/2017
28	Missing patient ID Activation Date: 11/01/2017
29	Missing patient name Activation Date: 11/01/2017
30	Invalid case number Activation Date: 11/01/2017
31	Missing case number Activation Date: 11/01/2017
32	Invalid provider address Activation Date: 11/01/2017
33	Missing provider address Activation Date: 11/01/2017
34	The referral number was not found. Activation Date: 11/01/2017
35	Invalid diagnosis code(s) Activation Date: 11/01/2017
36	Missing diagnosis code(s) Activation Date: 11/01/2017
37	Invalid procedure code(s) Activation Date: 11/01/2017
38	Missing procedure code(s) Activation Date: 11/01/2017
39	Invalid modifier code(s) Activation Date: 11/01/2017
40	Missing modifier code(s) Activation Date: 11/01/2017
41	Invalid authorization number Activation Date: 11/01/2017
42	Invalid referral number Activation Date: 11/01/2017
43	Missing referral number Activation Date: 11/01/2017
44	The authorized quantity of patient requests was exceeded. Activation Date: 11/01/2017
45	The provider is out of network for the member. Activation Date: 11/01/2017
46	The responding system is unable to complete the request at the current time. Activation Date: 11/01/2017
47	The provider ID does not match our records and we were not able to identify the provider. Activation Date: 11/01/2017
48	Inappropriate combination of qualifier and product or service code. Activation Date: 11/01/2017
49	Inappropriate combination of provider ID and taxonomy. Activation Date: 11/01/2017
50	Inappropriate combination of place of service and product or service code. Activation Date: 11/01/2017
51	Duplicate patient ID Activation Date: 11/01/2017
52	The service is inconsistent with the patient's age. Activation Date: 11/01/2017
53	The diagnosis is inconsistent with the patient's age. Activation Date: 11/01/2017
54	The patient's date of birth does not match our records. Activation Date: 11/01/2017
55	The subscriber or insured was not found. Activation Date: 11/01/2017
56	The subscriber ID or insured ID is not unique (returns multiple matches) in our records. Activation Date: 11/01/2017
57	Although the subscriber was found, the patient was not found. Activation Date: 11/01/2017
58	The submitted group or plan does not match our records. Activation Date: 11/01/2017
59	A response was not received from the information source's system. Activation Date: 11/01/2017
60	The submitted services are inconsistent with the submitted diagnosis code(s). Activation Date: 11/01/2017
61	Invalid provider ID Activation Date: 11/01/2017
62	Missing provider ID Activation Date: 11/01/2017
63	This service is not medically appropriate for this patient. Activation Date: 11/01/2017
64	The submitted authorization number does not match our records. Activation Date: 11/01/2017
65	Invalid date of birth Activation Date: 11/01/2017
66	Missing date of birth Activation Date: 11/01/2017
67	Missing gender code Activation Date: 11/01/2017
68	The provider ID does not match our records but we were able to identify the provider. Activation Date: 11/01/2017
69	Invalid member ID Activation Date: 11/01/2017
70	The responding system is unable to respond within the alloted time. Activation Date: 11/01/2017
71	Missing last name Activation Date: 11/01/2017
72	Missing first name Activation Date: 11/01/2017
73	Missing member ID Activation Date: 11/01/2017
74	The member ID does not match our records. Activation Date: 11/01/2017
75	The gender code does not match our records. Activation Date: 11/01/2017
76	The first name does not match our records. Activation Date: 11/01/2017
77	The last name does not match our records. Activation Date: 11/01/2017
78	The middle name does not match our records. Activation Date: 11/01/2017
79	Invalid name suffix Activation Date: 11/01/2017
80	Missing name suffix Activation Date: 11/01/2017
81	The name suffix does not match our records. Activation Date: 11/01/2017
82	There were duplicates within the minimum number of service types supported (ten), so there are fewer than ten responses. Activation Date: 11/01/2017
83	There were duplicate service type inquiries so the number of responses does not match the number of inquiries. Activation Date: 11/01/2017
84	The number of service type inquiries exceeds the number of responses we can return. Activation Date: 11/01/2017
85	We have responded with general benefit information, however the submitted procedure code requires separate medical review. Activation Date: 11/01/2017
86	We have responded, however the submitted procedure code requires separate medical review and prior authorization. Activation Date: 11/01/2017
87	We have responded with general benefit information, however the submitted service type code requires separate medical review. Activation Date: 11/01/2017
88	We have responded, however the submitted service type code requires separate medical review and prior authorization. Activation Date: 11/01/2017
89	Invalid group number Activation Date: 11/01/2017
90	Missing group number Activation Date: 11/01/2017
91	The responding system cannot process this real-time inquiry in real-time mode. Activation Date: 11/01/2017
92	Duplicate First Name Activation Date: 08/24/2018
93	Duplicate Last Name Activation Date: 08/24/2018
94	Duplicate Date of Birth Activation Date: 08/24/2018
95	Duplicate Policy/Policies Activation Date: 08/24/2018
96	Date range submitted exceeds a span of greater than 12 months. Please divide/split into more than one 270 inquiry with date ranges of 12 months or less in each inquiry. Activation Date: 08/24/2018
97	Inquiry Period Spans Too Large of a Date Range-Split the Request Into More Than One Separate Date Range Inquiries Activation Date: 08/24/2018