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Printed Date: 9/22/2015
The attending physician NPI on the claim is not present in the eligible attending physician file from PECOS or the attending physician NPI on the claim is present in the eligible attending physician files from PECOS, but the first four letters of the last name of the attending physician on the claim does not match the first four letters of the last name of the NPI record in the eligible attending physicians file from PECOS. Or the specialty code is not a valid eligible code.
Resources to avoid this error:
Verify the attending physician’s NPI and/or refer to the Internet-based PECOS.
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Last Updated: 12/27/2018