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CMS MLN Connects Special Edition for November 26, 2019

New Medicare Card: Claim Reject Codes After January 1, 2020

Get paid. Use Medicare Beneficiary Identifiers (MBIs) now.

If you do not use MBIs on claims (with a few exceptionsExternal link) after January 1, 2020, you will get:

  • Electronic claims reject codes: Claims Status Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber)
  • Paper claims notices: Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)” and Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”

We encourage people with Medicare to carry their cards with them since we removed the Social Security Number-based numbers; if your patients do not bring their Medicare cards with them:

  • Give them the Get Your New Medicare Card flyer in  English (PDF)External PDF file or  Spanish (PDF)External PDF file.
  • Use your Medicare Administrative Contractor’s look-up tool.  Sign upExternal PDF file for the Portal to use the tool.
  • Check the remittance advice. Until the end of December, we return the MBI on the remittance advice for every claim with a valid and active Health Insurance Claim Number.
See the  MLN Matters ArticleExternal PDF file to learn how to get and use MBIs.

Post Date: 11/27/19