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Error Reason Codes

X12 External Code Source 977

These codes describe a processing error related to a particular EDI transmission.

Last updated: 10/1/2019

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The list below shows the status of change requests which are in process.

Each request will be in one of the following statuses:

  1. Received
    The request has been submitted but is not yet under review.
  2. Triaged
    Staff has looked at the request to ensure it's a legitimate request (not spam), that it is assigned to the correct CMG, and that all required information is present.
  3. In Process
    The CMG has initiated their decision process.
  4. On Hold
    The CMG has initiated their decision process but cannot complete it at this time.
  5. CMG Approved
    The CMG has considered and approved the request, this does not mean it was approved exactly as submitted, it means maintenance related to the request was approved. Requests in this status will be applied to the next version.
  6. CMG Disapproved
    The CMG has considered and disapproved the request, no maintenance action will occur. Requests in this status are complete/final.
Num. Date Requested Description Type Code Status
No current requests. This list has been stable since the last update. It will not be updated until there are new requests.
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Use the form below to request maintenance to the Code List. Maintenance includes a request for a new code, a revision to the description of code, or deactivation of a code.

Note
The information submitted on this form may be edited for clarity or accuracy during the X12 triage and consideration processes.

Fields marked with an asterisk are required. Existing Code is required on requests for revision or deactivation of a code.

* Name
* Phone
* Email
* Request Type
Existing Code

* Brief description, published with the Code

Extended description, published with the Code

* Include the business justification for this maintenance request here, including who would benefit and the circumstances that make the request appropriate or necessary.

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01Inappropriate combination of service type code and service type code descriptor.
Activation Date: 11/01/2017
02Inappropriate service type code(s)
Activation Date: 11/01/2017
03The submitted procedure code(s) is not supported.
Activation Date: 11/01/2017
04Inquiries related to procedure codes are not supported.
Activation Date: 11/01/2017
05The submitted modifier code(s) is not supported.
Activation Date: 11/01/2017
06Inquiries related to modifier codes are not supported.
Activation Date: 11/01/2017
07The submitted diagnosis code(s) is not supported.
Activation Date: 11/01/2017
08Inquiries related to diagnosis codes are not supported.
Activation Date: 11/01/2017
09Duplicate ID
Activation Date: 11/01/2017 | Deactivation Date: 08/01/2019
10Invalid subscriber or insured ID
Activation Date: 11/01/2017
11Missing subscriber or insured ID
Activation Date: 11/01/2017
12Missing subscriber or insured name
Activation Date: 11/01/2017
13Invalid date of death
Activation Date: 11/01/2017
14Missing date of death
Activation Date: 11/01/2017
15Missing provider name
Activation Date: 11/01/2017
16Invalid taxonomy
Activation Date: 11/01/2017
17Missing taxonomy
Activation Date: 11/01/2017
18Missing provider state
Activation Date: 11/01/2017
19Invalid referring provider ID
Activation Date: 11/01/2017
20Missing referring provider ID
Activation Date: 11/01/2017
21The request date(s) is not within the provider's plan enrollment period.
Activation Date: 11/01/2017
22The request date(s) precedes the date of birth.
Activation Date: 11/01/2017
23The date of death in our records precedes the request date(s).
Activation Date: 11/01/2017
24The request date(s) is not within the allowable inquiry period.
Activation Date: 11/01/2017
25The request date(s) is in the future.
Activation Date: 11/01/2017
26Invalid request date(s)
Activation Date: 11/01/2017
27Invalid patient ID
Activation Date: 11/01/2017
28Missing patient ID
Activation Date: 11/01/2017
29Missing patient name
Activation Date: 11/01/2017
30Invalid case number
Activation Date: 11/01/2017
31Missing case number
Activation Date: 11/01/2017
32Invalid provider address
Activation Date: 11/01/2017
33Missing provider address
Activation Date: 11/01/2017
34The referral number was not found.
Activation Date: 11/01/2017
35Invalid diagnosis code(s)
Activation Date: 11/01/2017
36Missing diagnosis code(s)
Activation Date: 11/01/2017
37Invalid procedure code(s)
Activation Date: 11/01/2017
38Missing procedure code(s)
Activation Date: 11/01/2017
39Invalid modifier code(s)
Activation Date: 11/01/2017
40Missing modifier code(s)
Activation Date: 11/01/2017
41Invalid authorization number
Activation Date: 11/01/2017
42Invalid referral number
Activation Date: 11/01/2017
43Missing referral number
Activation Date: 11/01/2017
44The authorized quantity of patient requests was exceeded.
Activation Date: 11/01/2017
45The provider is out of network for the member.
Activation Date: 11/01/2017
46The responding system is unable to complete the request at the current time.
Activation Date: 11/01/2017
47The provider ID does not match our records and we were not able to identify the provider.
Activation Date: 11/01/2017
48Inappropriate combination of qualifier and product or service code.
Activation Date: 11/01/2017
49Inappropriate combination of provider ID and taxonomy.
Activation Date: 11/01/2017
50Inappropriate combination of place of service and product or service code.
Activation Date: 11/01/2017
51Duplicate patient ID
Activation Date: 11/01/2017 | Deactivation Date: 08/01/2019
52The service is inconsistent with the patient's age.
Activation Date: 11/01/2017
53The diagnosis is inconsistent with the patient's age.
Activation Date: 11/01/2017
54The patient's date of birth does not match our records.
Activation Date: 11/01/2017
55The subscriber or insured was not found.
Activation Date: 11/01/2017
56The subscriber ID or insured ID is not unique (returns multiple matches) in our records.
Activation Date: 11/01/2017 | Deactivation Date: 08/01/2019
57Although the subscriber was found, the patient was not found.
Activation Date: 11/01/2017
58The submitted group or plan does not match our records.
Activation Date: 11/01/2017
59A response was not received from the information source's system.
Activation Date: 11/01/2017
60The submitted services are inconsistent with the submitted diagnosis code(s).
Activation Date: 11/01/2017
61Invalid provider ID
Activation Date: 11/01/2017
62Missing provider ID
Activation Date: 11/01/2017
63This service is not medically appropriate for this patient.
Activation Date: 11/01/2017
64The submitted authorization number does not match our records.
Activation Date: 11/01/2017
65Invalid date of birth
Activation Date: 11/01/2017
66Missing date of birth
Activation Date: 11/01/2017
67Missing gender code
Activation Date: 11/01/2017
68The provider ID does not match our records but we were able to identify the provider.
Activation Date: 11/01/2017
69Invalid member ID
Activation Date: 11/01/2017
70The responding system is unable to respond within the alloted time.
Activation Date: 11/01/2017
71Missing last name
Activation Date: 11/01/2017
72Missing first name
Activation Date: 11/01/2017
73Missing member ID
Activation Date: 11/01/2017
74The member ID does not match our records.
Activation Date: 11/01/2017
75The gender code does not match our records.
Activation Date: 11/01/2017
76The first name does not match our records.
Activation Date: 11/01/2017
77The last name does not match our records.
Activation Date: 11/01/2017
78The middle name does not match our records.
Activation Date: 11/01/2017
79Invalid name suffix
Activation Date: 11/01/2017
80Missing name suffix
Activation Date: 11/01/2017
81The name suffix does not match our records.
Activation Date: 11/01/2017
82There were duplicates within the minimum number of service types supported (ten), so there are fewer than ten responses.
Activation Date: 11/01/2017
83There were duplicate service type inquiries so the number of responses does not match the number of inquiries.
Activation Date: 11/01/2017
84The number of service type inquiries exceeds the number of responses we can return.
Activation Date: 11/01/2017
85We have responded with general benefit information, however the submitted procedure code requires separate medical review.
Activation Date: 11/01/2017
86We have responded, however the submitted procedure code requires separate medical review and prior authorization.
Activation Date: 11/01/2017
87We have responded with general benefit information, however the submitted service type code requires separate medical review.
Activation Date: 11/01/2017
88We have responded, however the submitted service type code requires separate medical review and prior authorization.
Activation Date: 11/01/2017
89Invalid group number
Activation Date: 11/01/2017
90Missing group number
Activation Date: 11/01/2017
91The responding system cannot process this real-time inquiry in real-time mode.
Activation Date: 11/01/2017
92Duplicate first name
Activation Date: 08/24/2018
93Duplicate last name
Activation Date: 08/24/2018
94Duplicate date of birth
Activation Date: 08/24/2018
95Duplicate policy(s)
Activation Date: 08/24/2018
96A date range greater than 12 months is not supported.
Activation Date: 08/24/2018
97The date range of the inquiry exceeds the period of time supported.
Activation Date: 08/24/2018
98The member ID is not unique (returns multiple matches) in our records.
Activation Date: 08/01/2019
99Inappropriate combination of service type codes
Activation Date: 08/01/2019
100Service type code(s) on this request is valid only for responses and is not valid on requests.
Activation Date: 08/01/2019
101The provider ID does match our records but has not met the eligibility requirements to send or receive this transaction.
Activation Date: 08/01/2019
102Benefit utilization information for this response, such as remaining or accumulator amounts, is restricted by the responding system.
Activation Date: 10/01/2019