Explanations of Benefits (EOBs) Codes for Claim Denials Related to NPI and Taxonomy Codes
Get It! Share It! Use It!
Getting one is free -
Not having one can be costly!
The following EOB codes indicate claim denials related
to NPIs and taxonomy codes:
- EOB 3091 -
Billing NPI and/or Billing Taxonomy is missing. Attending NPI and/or Attending
Taxonomy, when required, is missing.
- EOB 3092 -
Billing NPI and/or Billing Taxonomy is missing.
- EOB 3093 -
Attending NPI and/or Attending Taxonomy, when required, is missing.
- EOB 3094 -
Referring NPI is missing.
- EOB
3101 - Taxonomy code for attending
provider is missing.
- EOB
3102 - Taxonomy code for billing
provider is missing.
- EOB
3208 - Void or adjustment cannot
be processed. Billing NPI does not match NPI on file for original provider.
- EOB
3209 - Void or adjustment cannot
be processed. Billing NPI does not match NPI filed on original claim.
The following EOB codes indicate pharmacy claim denials
related to NPI:
- EOB
3106 - The NPI submitted for the
prescribing provider cannot be the same as the pharmacy’s NPI.
- EOB
1801 - Service Provider ID Qualifier
is not 01.
- EOB
1802 - Service Provider ID is not
numeric.
The following EOB codes have been modified to include
NPI-related claim denials:
- EOB
270 - Billing provider is not the
recipient’s Carolina Access PCP. Authorization is missing or unresolved. Contact
PCP for authorization or EDS [HP Enterprise Services] Provider Services if authorization is correct.
- EOB
3007 (for Hospice) -
Patient facility identification
is missing, invalid, or unresolved. Verify patient facility ID and resubmit
as a new claim or contact EDS [HP Enterprise Services] Provider Services if ID is correct.
- EOB
8326 - Attending provider ID is missing
or unresolved. Attending provider is required. Verify attending provider
ID and resubmit as a new claim or contact EDS [HP Enterprise Services] Provider Services if ID is
correct.
- EOB
2270 - Service must be referred by
Carolina Access PCP, LME, or Medicaid enrolled psychiatrist. Enter referral
# on claim or contact EDS [HP Enterprise Services] Provider Services if referral # is correct.
