Corporate

October 29, 2019

New Medicare Card: Claim Reject Codes After January 1

Starting January 1, 2020, you must use Medicare Beneficiary Identifiers (MBIs) when billing Medicare regardless of the date of service:

  • We will reject claims submitted with Health Insurance Claim Numbers (HICNs) with a few exceptionsExternal Website
  • We will reject all eligibility transactions submitted with HICNs

If you do not use MBIs on claims after January 1, you will get: 

  • Electronic claims reject codes: Claims Status Category Code of A7 (acknowledgment rejected for invalid information), a Claims Status Code of 164 (entity’s contract/member number), and an Entity Code of IL (subscriber)
  • Paper claims notices: Claim Adjustment Reason Code (CARC) 16 “Claim/service lacks information or has submission/billing error(s)” and Remittance Advice Remark Code (RARC) N382 “Missing/incomplete/invalid patient identifier”

Do not wait. Protect your patients’ identities by using MBIs now for all Medicare transactions. Need an MBI?

  • Ask your patients for their cards. If they did not get a new card, give them the Get Your New Medicare Card flyer in EnglishExternal PDF or SpanishExternal PDF.
  • Use the myCGS MBI Look-Up Tool. Sign up for the myCGS Portal to use the tool.
  • Check the remittance advice. We return the MBI on the remittance advice for every claim with a valid and active HICN.

For more information, see the MLN Matters Article, SE18006External PDF.

Was this page helpful? YES NO


Two Vantage Way, Nashville, TN 37228 © CGS Administrators, LLC. All Rights Reserved