Remark code N259 indicates that the claim submitted has an issue with the secondary identifier for the billing provider or supplier. This could mean that the necessary secondary identifier is missing, incomplete, or invalid on the claim form. To resolve this, the provider must ensure that all required identifiers are correctly included on the claim before resubmission.
Common causes of code N259 are:
1. The secondary identifier field on the claim form is left blank.
2. The entered secondary identifier is incorrect or does not match the information on file with the payer.
3. The claim was submitted without the necessary qualifier to indicate the type of secondary identifier provided.
4. The billing provider's NPI (National Provider Identifier) is not properly linked to their Tax Identification Number (TIN) or Employer Identification Number (EIN) in the payer's system.
5. The claim form includes an outdated or deactivated secondary identifier, such as an old Medicare UPIN (Unique Physician Identification Number) that is no longer valid.
6. The secondary identifier is not appropriate for the billing provider type or specialty.
7. The information for the secondary identifier is not correctly formatted according to the payer's specifications.
8. The claim was submitted electronically, and there was an error in the electronic data interchange (EDI) transmission that caused the secondary identifier to be omitted or corrupted.
Ways to mitigate code N259 include implementing a thorough review process for all claims before submission to ensure that the billing provider or supplier's secondary identifier, such as a National Provider Identifier (NPI) for the secondary location or taxonomy code, is present and accurately entered. Training staff on the importance of complete and accurate data entry and routinely auditing claims can help identify and correct common errors. Utilizing electronic health record (EHR) systems with built-in validation checks can also prevent the omission or incorrect entry of secondary identifiers. Regularly updating provider information in the practice management system to reflect any changes in secondary identifiers is crucial to avoid this denial code.
The steps to address code N259 involve a thorough review and correction process. Begin by verifying the billing provider or supplier information on the claim. Ensure that all required secondary identifiers, such as NPI (National Provider Identifier) or tax ID numbers, are present and accurately entered. If the secondary identifier is missing, obtain the correct information and update the claim accordingly. In the case of an incomplete or invalid identifier, cross-reference the information with your records or the provider's enrollment details to correct any discrepancies. Once the necessary corrections are made, resubmit the claim for processing. It's also advisable to review your claim submission protocols to prevent similar issues in future billing cycles.