CARC 207 Active

CO-207: National Provider Identifier - Invalid Format

TL;DR

Correct the NPI to the proper 10-digit format and resubmit. Do not appeal.

Action
Verify & Resubmit
Who Pays
Provider
Appeal
No
Patient Impact
None
Disclaimer
This content is for informational purposes only and does not constitute professional billing advice. Always verify information against your payer contracts and current coding guidelines. Consult a certified billing specialist for specific claim issues.

What Does CO-207 Mean?

With CO (Contractual Obligation), the invalid NPI format is the provider's responsibility. Correct the NPI format and resubmit. Do not appeal — this is a data correction issue.

CARC 207 indicates that the NPI submitted on the claim does not conform to the required format. A valid NPI must be exactly 10 numeric digits and must pass the Luhn algorithm check digit validation. This denial occurs when the NPI contains letters, special characters, or spaces, when it has too few or too many digits, when it fails the check digit validation, or when a legacy provider number was entered in the NPI field.

This is a data entry or system configuration error, not a coverage denial. The fix is to correct the NPI to the proper format and resubmit.

Common Causes

Cause Frequency
NPI does not meet the 10-digit format requirement The NPI submitted on the claim does not consist of exactly 10 numeric digits, which is the required format per CMS standards Most Common
NPI contains letters or special characters The NPI field contains non-numeric characters, spaces, or special characters that make the format invalid Common
NPI check digit validation failure The NPI does not pass the Luhn algorithm check digit validation, indicating the number itself is not a valid NPI Common
Truncated or partial NPI submitted Only a portion of the 10-digit NPI was entered due to data entry error or system truncation Common
Legacy provider number used instead of NPI An older provider identification number (UPIN, PIN, or other legacy ID) was entered in the NPI field Occasional

How to Resolve

  1. Verify the correct NPI Look up the provider's NPI in the NPPES registry.
  2. Correct and resubmit Enter the valid 10-digit NPI and resubmit the claim.
  3. Update your system Fix the provider record in your billing system to prevent recurring format errors.
Do Not Appeal This Code

The NPI on the claim has an invalid format. This is a data entry error. Correct the NPI to the proper 10-digit numeric format and resubmit the claim.

Common RARC Pairings

The RARC code tells you exactly what triggered the CO-207:

RARC Description
MA130 Your claim contains incomplete and/or invalid information, and no appeal rights are afforded. Correct the NPI format and resubmit the claim as a new submission →
N285 Missing/incomplete/invalid referring provider information. Correct the referring provider NPI format and resubmit →

How to Prevent CO-207

Also Filed As

The same CARC 207 may appear with different Group Codes:

OA-207 PR-207

Related Denial Codes

CO-206 — National Provider Identifier - Missing CO-208 — National Provider Identifier - Not Matched CO-16 — Missing Information or Billing Error CO-226 — Provider Information Not Provided or Insufficient CO-227 — Patient/Insured Information Not Provided or Insufficient

Sources

  1. https://x12.org/codes/claim-adjustment-reason-codes
  2. https://www.mdclarity.com/denial-code/207
  3. https://med.noridianmedicare.com/web/jeb/topics/claim-submission/reason-code-guidance/missing-incorrect-req-npi-info
  4. Codes maintained by X12. Visit x12.org for official definitions.