999 Rejections
Corporate

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May 3, 2016

999 Rejections

Information submitted IK3 Error IK4 Error The problem is with the Error resolution
N3*~ IK3*N3*17*2310*8 IK4*1*166*1 N3 Address Street address must be submitted
N4*~ IK3*N4*18*2310*8 IK4*1*19*1 N4 City, State and Zip Code The city, state and a valid 9 digit postal Zip code must be submitted
  IK3*REF*30*2300*I6   Missing Ref segment A ref segment with the Payer Claim Control Number is required when ClM05-3 indicates this claim is a replacement or void to a previously adjudicated claim Note (Part A and HHH only)
NM1*82*1*SMITH*MaryA R ****XX*1111111111 IK3*NM1*538*2310*8~ IK4*4*1036*7 NM1 Rendering Provider name segment The trailing space after the provider name must be removed
NM1*IL*1*SMITH*JOHN*R***MI~ IK3*NM1*886*2330*8 IK4*9*67*1 Identification Code is missing The Subscribers Identification number must be submitted

IK301 Segment ID
IK302 Segment count of this data segment beginning with ST
IK303 Loop Identifier Code
IK304 Segment Syntax Error Code
IK401 Position in the segment
IK403 Data element syntax error code
IK404 Copy of the bad data

For more information on how to read the 999 please view the ASC X12N v005010 Job AidPDF.


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