CARC 207 Active

OA-207: National Provider Identifier - Invalid Format

TL;DR

The invalid NPI was flagged during COB. Correct and resubmit.

Action
Verify & Resubmit
Who Pays
Depends
Appeal
No
Patient Impact
Indirect
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 OA-207 Mean?

With OA (Other Adjustments), the invalid NPI format was flagged during coordination of benefits. Correct the NPI and resubmit.

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
Invalid NPI format in secondary claim submission An incorrectly formatted NPI was forwarded to the secondary payer Common

How to Resolve

  1. Correct the NPI Enter the valid 10-digit NPI.
  2. Resubmit Submit the corrected claim.
Do Not Appeal This Code

The NPI format is invalid. Correct the NPI and resubmit the claim.

How to Prevent OA-207

Also Filed As

The same CARC 207 may appear with different Group Codes:

CO-207 PR-207

Related Denial Codes

OA-16 — Missing Information or Billing Error OA-146 — Diagnosis Invalid for Date of Service OA-148 — Information from Another Provider Not Provided or Incomplete OA-175 — Prescription Is Incomplete OA-181 — Procedure Code Invalid on Date of Service

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.