Status Last Reviewed: 12/1/2024
| 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. | |||||
Error Reason Codes
977
These codes describe a processing error related to a particular EDI transmission.
Maintenance Request Status
The list below shows the status of change requests which are in process.
Each request will be in one of the following statuses:
- Received
The request has been submitted but is not yet under review. - Pending
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. - In Process
The CMG has initiated their decision process. - On Hold
The CMG has initiated their decision process but cannot complete it at this time. - 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. - CMG Disapproved
The CMG has considered and disapproved the request, no maintenance action will occur. Requests in this status are complete/final.
7/1/2021
| 01 | Inappropriate combination of service type code and service type code descriptor. Activation Date: 11/01/2017 |
| 02 | Inappropriate service type code(s) Activation Date: 11/01/2017 |
| 03 | The submitted procedure code(s) is not supported. Activation Date: 11/01/2017 |
| 04 | Inquiries related to procedure codes are not supported. Activation Date: 11/01/2017 |
| 05 | The submitted modifier code(s) is not supported. Activation Date: 11/01/2017 |
| 06 | Inquiries related to modifier codes are not supported. Activation Date: 11/01/2017 |
| 07 | The submitted diagnosis code(s) is not supported. Activation Date: 11/01/2017 |
| 08 | Inquiries related to diagnosis codes are not supported. Activation Date: 11/01/2017 |
| 09 | Duplicate ID Activation Date: 11/01/2017 | Deactivation Date: 08/01/2019 |
| 10 | Invalid subscriber or insured ID Activation Date: 11/01/2017 |
| 11 | Missing subscriber or insured ID Activation Date: 11/01/2017 |
| 12 | Missing subscriber or insured name Activation Date: 11/01/2017 |
| 13 | Invalid date of death Activation Date: 11/01/2017 |
| 14 | Missing date of death Activation Date: 11/01/2017 |
| 15 | Missing provider name Activation Date: 11/01/2017 |
| 16 | Invalid taxonomy Activation Date: 11/01/2017 |
| 17 | Missing taxonomy Activation Date: 11/01/2017 |
| 18 | Missing provider state Activation Date: 11/01/2017 |
| 19 | Invalid referring provider ID Activation Date: 11/01/2017 |
| 20 | Missing referring provider ID Activation Date: 11/01/2017 |
| 21 | The request date(s) is not within the provider's plan enrollment period. Activation Date: 11/01/2017 |
| 22 | The request date(s) precedes the date of birth. Activation Date: 11/01/2017 |
| 23 | The date of death in our records precedes the request date(s). Activation Date: 11/01/2017 |
| 24 | The request date(s) is not within the allowable inquiry period. Activation Date: 11/01/2017 |
| 25 | The request date(s) is in the future. Activation Date: 11/01/2017 |
| 26 | Invalid request date(s) Activation Date: 11/01/2017 |
| 27 | Invalid patient ID Activation Date: 11/01/2017 |
| 28 | Missing patient ID Activation Date: 11/01/2017 |
| 29 | Missing patient name Activation Date: 11/01/2017 |
| 30 | Invalid case number Activation Date: 11/01/2017 |
| 31 | Missing case number Activation Date: 11/01/2017 |
| 32 | Invalid provider address Activation Date: 11/01/2017 |
| 33 | Missing provider address Activation Date: 11/01/2017 |
| 34 | The referral number was not found. Activation Date: 11/01/2017 |
| 35 | Invalid diagnosis code(s) Activation Date: 11/01/2017 |
| 36 | Missing diagnosis code(s) Activation Date: 11/01/2017 |
| 37 | Invalid procedure code(s) Activation Date: 11/01/2017 |
| 38 | Missing procedure code(s) Activation Date: 11/01/2017 |
| 39 | Invalid modifier code(s) Activation Date: 11/01/2017 |
| 40 | Missing modifier code(s) Activation Date: 11/01/2017 |
| 41 | Invalid authorization number Activation Date: 11/01/2017 |
| 42 | Invalid referral number Activation Date: 11/01/2017 |
| 43 | Missing referral number Activation Date: 11/01/2017 |
| 44 | The authorized quantity of patient requests was exceeded. Activation Date: 11/01/2017 |
| 45 | The provider is out of network for the member. Activation Date: 11/01/2017 |
| 46 | The responding system is unable to complete the request at the current time. Activation Date: 11/01/2017 |
| 47 | The provider ID does not match our records and we were not able to identify the provider. Activation Date: 11/01/2017 |
| 48 | Inappropriate combination of qualifier and product or service code. Activation Date: 11/01/2017 |
| 49 | Inappropriate combination of provider ID and taxonomy. Activation Date: 11/01/2017 |
| 50 | Inappropriate combination of place of service and product or service code. Activation Date: 11/01/2017 |
| 51 | Duplicate patient ID Activation Date: 11/01/2017 | Deactivation Date: 08/01/2019 |
| 52 | The service is inconsistent with the patient's age. Activation Date: 11/01/2017 |
| 53 | The diagnosis is inconsistent with the patient's age. Activation Date: 11/01/2017 |
| 54 | The patient's date of birth does not match our records. Activation Date: 11/01/2017 |
| 55 | The subscriber or insured was not found. Activation Date: 11/01/2017 |
| 56 | The subscriber ID or insured ID is not unique (returns multiple matches) in our records. Activation Date: 11/01/2017 | Deactivation Date: 08/01/2019 |
| 57 | Although the subscriber was found, the patient was not found. Activation Date: 11/01/2017 |
| 58 | The submitted group or plan does not match our records. Activation Date: 11/01/2017 |
| 59 | A response was not received from the information source's system. Activation Date: 11/01/2017 |
| 60 | The submitted services are inconsistent with the submitted diagnosis code(s). Activation Date: 11/01/2017 |
| 61 | Invalid provider ID Activation Date: 11/01/2017 |
| 62 | Missing provider ID Activation Date: 11/01/2017 |
| 63 | This service is not medically appropriate for this patient. Activation Date: 11/01/2017 |
| 64 | The submitted authorization number does not match our records. Activation Date: 11/01/2017 |
| 65 | Invalid date of birth Activation Date: 11/01/2017 |
| 66 | Missing date of birth Activation Date: 11/01/2017 |
| 67 | Missing gender code Activation Date: 11/01/2017 |
| 68 | The provider ID does not match our records but we were able to identify the provider. Activation Date: 11/01/2017 |
| 69 | Invalid member ID Activation Date: 11/01/2017 |
| 70 | The responding system is unable to respond within the alloted time. Activation Date: 11/01/2017 |
| 71 | Missing last name Activation Date: 11/01/2017 |
| 72 | Missing first name Activation Date: 11/01/2017 |
| 73 | Missing member ID Activation Date: 11/01/2017 |
| 74 | The member ID does not match our records. Activation Date: 11/01/2017 |
| 75 | The gender code does not match our records. Activation Date: 11/01/2017 |
| 76 | The first name does not match our records. Activation Date: 11/01/2017 |
| 77 | The last name does not match our records. Activation Date: 11/01/2017 |
| 78 | The middle name does not match our records. Activation Date: 11/01/2017 |
| 79 | Invalid name suffix Activation Date: 11/01/2017 |
| 80 | Missing name suffix Activation Date: 11/01/2017 |
| 81 | The name suffix does not match our records. Activation Date: 11/01/2017 |
| 82 | There were duplicates within the minimum number of service types supported (ten), so there are fewer than ten responses. Activation Date: 11/01/2017 |
| 83 | There were duplicate service type inquiries so the number of responses does not match the number of inquiries. Activation Date: 11/01/2017 |
| 84 | The number of service type inquiries exceeds the number of responses we can return. Activation Date: 11/01/2017 |
| 85 | We have responded with general benefit information, however the submitted procedure code requires separate medical review. Activation Date: 11/01/2017 |
| 86 | We have responded, however the submitted procedure code requires separate medical review and prior authorization. Activation Date: 11/01/2017 |
| 87 | We have responded with general benefit information, however the submitted service type code requires separate medical review. Activation Date: 11/01/2017 |
| 88 | We have responded, however the submitted service type code requires separate medical review and prior authorization. Activation Date: 11/01/2017 |
| 89 | Invalid group number Activation Date: 11/01/2017 |
| 90 | Missing group number Activation Date: 11/01/2017 |
| 91 | The responding system cannot process this real-time inquiry in real-time mode. Activation Date: 11/01/2017 |
| 92 | Duplicate first name Activation Date: 08/24/2018 |
| 93 | Duplicate last name Activation Date: 08/24/2018 |
| 94 | Duplicate date of birth Activation Date: 08/24/2018 |
| 95 | Duplicate policy(s) Activation Date: 08/24/2018 |
| 96 | A date range greater than 12 months is not supported. Activation Date: 08/24/2018 |
| 97 | The date range of the inquiry exceeds the period of time supported. Activation Date: 08/24/2018 |
| 98 | The member ID is not unique (returns multiple matches) in our records. Activation Date: 08/01/2019 |
| 99 | Inappropriate combination of service type codes Activation Date: 08/01/2019 |
| 100 | Service type code(s) on this request is valid only for responses and is not valid on requests. Activation Date: 08/01/2019 |
| 101 | The provider ID does match our records but has not met the eligibility requirements to send or receive this transaction. Activation Date: 08/01/2019 |
| 102 | Benefit utilization information for this response, such as remaining or accumulator amounts, is restricted by the responding system. Activation Date: 10/01/2019 |
| 103 | Information source is not responding; clearinghouse/intermediary has temporarily suspended request submissions. Activation Date: 07/01/2021 |
| 104 | Information Source's system encountered errors preventing benefit related information from being returned. Activation Date: 07/01/2021 |
| 105 | Information Source's system encountered errors preventing eligibility, coverage and/or policy related information from being returned. Activation Date: 07/01/2021 |