HCSC NPI EDIT UPDATE NOTIFICATION EFFECTIVE 10/28/07
Posted 11/26/07
Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, Blue Cross and Blue Shield of New Mexico and Blue Cross and Blue Shield of Oklahoma

HCSC NPI Only Submission Edits will be set to Reject (“R”) effective 10/28/07.

QBK - Tax ID is missing
QGC – Billing NPI is not on file
QGD – NPI is not valid as billing

The following edit rejections apply to Texas, New Mexico and Oklahoma only.
These edits will remain as a Warning (W) for Illinois at this time.

BA4 – Rendering Provider NPI Invalid
BA5 – Rendering Provider ID Qualifier Must = ‘XX’
BA6 – Rendering NPI is not on file
BA7 – NPI is not Valid as Rendering
CA4 – Rendering Provider NPI Invalid
CA5 – Rendering Provider ID qualifier Must = ‘XX’
CA6 – Rendering NPI is not on file
CA7 – Rendering NPI is not valid as Rendering

Note:

QGA – Billing Provider NPI missing and is required - will remain as a Warning (W) on any electronic claim submission until further notice.

QBD - is an existing edit that is designed for the “Legacy and NPI (DUAL ID)” submissions – if the NPI is present but the Legacy ID is not given on the claim - it will continue to reject with this QBD edit until the HCSC provider is approved for NPI only submission. Continue submitting the Legacy and NPI Numbers until the provider alerts you that they are approved to submit NPI only.

If you have any questions on these edits, please contact our E-Commerce Center at 1.800.746.4614.