CLIA - Invalid Credentials - JF Part B
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 the Appeals webpage for instructions on how to submit a Reopening or Redetermination
Claim Submission Tips
- How to Apply for a CLIA Certificate, Including International Laboratories - Apply for CLIA Certification prior to rendering lab services
- Categorization of Tests - Review codes that require a CLIA certification number
- Tests Granted Waived Status Under CLIA - Refer to the List of Waived Tests to determine which codes require modifier QW (CLIA waived tests)
- Not all CLIA waived tests require modifier QW
Last Updated Dec 09 , 2023
