207Denial Code (CARC)Active
CO 207 Denial Code - Fix Invalid NPI Format Errors
CARC 207 indicates that the National Provider Identifier (NPI) submitted on the claim is in an invalid format. This means the NPI does not meet the required 10-digit numerical format, leading to the claim's rejection.
Who Pays: Group Code Liability
The group code for CARC 207 is typically CO, meaning the provider must correct the error and cannot bill the patient.
Why Claims Get Code 207
- Transposing numbers in the NPI during claim entry.
- Entering an NPI with fewer than 10 digits.
- Using alphabetic characters or symbols in the NPI field.
- Submitting an NPI that includes spaces or dashes.
- Copy-pasting the NPI from a document that adds hidden characters.
How to Fix & Resubmit
- Verify the NPI entered on the claim against the provider's official records.
- Ensure the NPI is exactly 10 digits and contains only numbers.
- Correct any formatting issues, such as removing spaces or dashes.
- Update the claim form with the corrected NPI.
- Resubmit the corrected claim to the payer.
Corrected Claim or Appeal?
For CARC 207, submitting a corrected claim with the properly formatted NPI is necessary. Appeals are not applicable as this is a data entry error.
Preventing Future 207 Denials
- Double-check NPI entries against official records before claim submission.
- Implement validation checks in the billing software for NPI format.
- Train staff on the correct NPI format to avoid common errors.
- Use electronic verification tools to confirm NPI validity before claims go out.