Physician/supplier signature
MA81: Missing/incomplete/invalid provider/supplier signature.
• Refer to Item 31 on the claim form. The signature of the physician or non-physician practitioner is required. The following formats are acceptable.
• Actual signature
• “Signature on file” notation (if applicable)
• Computer-generated signature
Primary or secondary payer information
MA83: Did not indicate whether Medicare is the primary or secondary payer.
• Refer to Item 11 on the claim form. This is a required field. By completing this item, a physician/supplier acknowledges that he/she made a good faith effort to determine whether Medicare is the primary or secondary payer.
• If Medicare is primary, enter the word “NONE.”
• If Medicare is secondary, enter the insured’s policy or group number, and precede with Items 11a -11c.
• Note: Items 4, 6 and 7 must also be completed.
Procedure codes
M51: Missing/incomplete/invalid procedure code(s).
• Refer to Item 24D on the claim form. Before submitting your claim, ensure you use the most current year's Current Procedural Terminology (CPT®) and/or Healthcare Common Procedure Coding System (HCPCS) codes.
Rendering physician NPI
N290: Missing/incomplete/invalid rendering provider primary identifier.
MA112: Missing/incomplete/invalid group practice information.
• Refer to Item 24J on the claim form. If the rendering provider is linked to the group, enter the individual practitioner’s NPI in the unshaded portion of this field.