Denial code N254

Remark code N254 indicates an issue with a missing or incorrect secondary identifier for the attending provider in a claim.

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What is Denial Code N254

Remark code N254 indicates that the claim submitted lacks a complete and valid secondary identifier for the attending provider. This could mean that the necessary information was not provided, was incomplete, or the identifier included does not meet the required standards or formats. To resolve this issue, the healthcare provider must review the claim, ensure that the correct secondary identifier is included, and resubmit the claim for processing.

Common Causes of RARC N254

Common causes of code N254 are:

1. The claim was submitted without the required secondary identifier for the attending provider, such as a taxonomy code or a state license number.

2. The secondary identifier provided on the claim is incorrect or does not match the information on file with the payer.

3. The attending provider's secondary identifier is incomplete, possibly due to a data entry error or omission.

4. The format of the secondary identifier is not in accordance with the payer's specifications, which may vary by insurer.

5. The claim form may have been updated or changed, and the secondary identifier was not properly transcribed or carried over to the new form.

6. The electronic claim submission may have encountered a technical issue that resulted in the loss or corruption of the secondary identifier information.

7. The payer's system may require a specific type of secondary identifier that was not included, such as a Provider Transaction Access Number (PTAN) for Medicare claims.

Ways to Mitigate Denial Code N254

Ways to mitigate code N254 include implementing a robust verification process for all provider information before claim submission. Ensure that the attending provider's secondary identifier, such as a state license number or unique provider identification number (UPIN), is accurately recorded and updated in the practice management system. Regularly train billing staff on the importance of double-checking these identifiers and establish a system of checks and balances to catch any missing or incorrect information. Utilize electronic health record (EHR) systems with built-in validation tools that alert users to incomplete or invalid data entries. Additionally, maintain open communication with attending providers to promptly obtain any necessary identifier updates or corrections.

How to Address Denial Code N254

The steps to address code N254 involve verifying and updating the attending provider's information in the claim submission. First, review the claim to ensure that the attending provider's National Provider Identifier (NPI) is present and accurately entered. If the NPI is missing, obtain it from the provider's office or the National Plan & Provider Enumeration System (NPPES) and add it to the claim. If the NPI is incorrect, correct the information and resubmit the claim. Additionally, check for any other required secondary identifiers that may be specific to the payer or the type of service provided, such as a taxonomy code or state license number, and update the claim accordingly. Once all provider identifiers are confirmed to be accurate and complete, resubmit the claim to the payer for processing. It's also advisable to review your practice's claim submission processes to prevent future occurrences of this error.

CARCs Associated to RARC N254

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