Reason Code 16 | Remark Code MA27 N382

Code Description
Reason Code: 16 Claim/service lacks information or has submission/billing error(s).
Remark Codes: MA27 and N382
  • Missing/incomplete/invalid entitlement number or name shown on the claim.
  • Missing/incomplete/invalid patient identifier.

Common Reasons for Denial

  • Patient Medicare Beneficiary Identifier (MBI) number is invalid or was not submitted.
  • Beneficiary name/Medicare number do not match.

Next Step

  • Beneficiaries receive a new Medicare Beneficiary Identifier (MBI) number when they report their Medicare card lost or stolen. Once that new MBI number is received, suppliers must immediately switch to billing with the new MBI. Correct claim and resubmit as a new claim with the new MBI.
  • Ensure correct name and MBI number match obtained from the Medicare card. Correct claim and resubmit as a new claim.
  • Verify that the following information is exactly as indicated on their Medicare card.
    • Medicare Beneficiary Identifier (MBI) number
    • First and last name (in proper order)

How to Avoid Future Denials

  • Always verify eligibility including the beneficiaries MBI using the NMP MBI Lookup Tool or obtain  beneficiaries Medicare Beneficiary Identifier (MBI) number directly from their most current Medicare card.
    • Keep a copy on file
  • If the record on file is incorrect, the beneficiary, their family/estate must contact the Social Security Administration to make necessary correction(s) to have records corrected.
Last Updated Apr 19 , 2024