Reason Code 16 | Remark Codes N286 - JA DME

Common Reasons for Denial

• The referring provider identifier is missing, incomplete or invalid

Next Step

• Correct claim with complete referring provider identifier in box 17 of the 1500 form or electronic equivalent and resubmit claim. Do not extend the name beyond the confines of this box. Only enter what will fit into item 17. Do not run name into item 17a or 17b. The ordering physician’s name should be in this exact format: First name, last name, no middle initial and no credentials. An invalid physician name will cause a claim to deny or be rejected as unprocessable.

How to Avoid Future Denials

• Ensure that referring provider is identified on the claim in box 17, prior to claim submission. Do not extend the name beyond the confines of this box. Only enter what will fit into item 17. Do not run name into item 17a or 17b. The ordering physician’s name should be in this exact format: First name, last name, no middle initial and no credentials. An invalid physician name will cause a claim to deny or be rejected as unprocessable.
• Ensure software systems are updated with correct information to avoid future errors.