CARC 208 Active

OA-208: National Provider Identifier - Not Matched

TL;DR

The NPI does not match the secondary payer's records. Verify enrollment 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-208 Mean?

With OA (Other Adjustments), the NPI mismatch was found with the secondary payer. The provider may be enrolled with the primary payer but not the secondary. Verify enrollment and resubmit.

CARC 208 indicates that the NPI submitted on the claim has a valid format but does not match any provider in the payer's enrollment records. This typically means the provider is not enrolled with the payer, a different NPI was entered by mistake, the NPI has been deactivated, or the wrong NPI type (individual vs. organizational) was used.

Unlike CARC 206 (NPI missing) or CARC 207 (NPI invalid format), CARC 208 specifically means the NPI exists in the NPPES registry but does not correspond to a provider the payer recognizes. The most common resolution is to verify and correct the NPI or complete provider enrollment with the payer.

Common Causes

Cause Frequency
NPI mismatch with secondary payer records The NPI does not match the secondary payer's enrollment file even though it matches the primary payer Common

How to Resolve

  1. Verify enrollment with the secondary payer Check that the provider is enrolled with the secondary payer.
  2. Correct and resubmit Use the correct NPI and resubmit.
Do Not Appeal This Code

The NPI does not match the secondary payer's records. Verify enrollment and resubmit.

How to Prevent OA-208

Also Filed As

The same CARC 208 may appear with different Group Codes:

CO-208 PR-208

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/208
  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.