CLIA - Invalid Credentials

CARC/RARC Description
CO-B7 This provider was not certified/eligible to be paid for this procedure/service on this date of service. Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.
N570 Missing/incomplete/invalid credentialing data.

 

Common Reasons for Message

  • Lab code billed is not within CLIA certification type
  • CLIA waived test was missing modifier QW
  • Modifier QW was billed but not required

Next Step

  • Verify correct CLIA certification number was submitted on claim
  • Submit Appeal request to correct CLIA certification number or add/remove QW modifier
    • See Appeals webpage for instructions on how to submit a Reopening or Redetermination

Claim Submission Tips

View reason code list, return to Reason Code Guidance page.

 

Last Updated May 21, 2018