N286 Denial Code: Referring provider identifier missing or invalid
The payer could not find or validate the referring provider's primary identifier (the individual NPI). Fix item 17/17b or loop 2310A and resubmit - this remark typically arrives alongside CO-16.
- Group code
- N/A (no group code)
- Code type
- RARC
- Billable to patient?
- No - correct the claim and resubmit; do not bill the patient
- Appealable?
- Fix and resubmit - no appeal needed
- Category
- Missing or Invalid Information
LQ*HE*N286Appears as a remark code alongside a claim adjustment reason code.What N286 means
N286 is an informational remark that rides along with a claim-level CARC (most often CO-16) to pinpoint the problem: the payer could not find or validate the referring provider's primary identifier, which is the individual NPI. On paper claims the referring provider goes in item 17 with the NPI in 17b; electronically it is loop 2310A. Payers use this identifier to confirm the referral chain and, for Medicare, to verify the referring provider is enrolled in PECOS. Because the claim was never judged on its merits, the remedy is a corrected resubmission, not an appeal.
Common causes
- The referring provider's NPI was omitted from item 17b or loop 2310A.
- A typo in the NPI, or the provider's name does not match what NPPES has on file for that number.
- An organizational NPI was used where the payer requires the individual referring provider's NPI.
- The wrong qualifier was sent, so the payer could not read the identifier.
- For Medicare, the referring provider is not enrolled in PECOS, so the edit fails even with a valid NPI.
- The referral was attributed to the wrong provider in your PM system.
How to fix it
- Confirm the referring provider's individual NPI and exact name in the NPPES NPI Registry.
- For Medicare, check the CMS Ordering and Referring file to verify the provider is listed as eligible to order and refer.
- Correct item 17/17b or loop 2310A and resubmit; Medicare unprocessable rejections go back as new claims, while other payers may want a corrected-claim resubmission.
- If the referrer is not PECOS-enrolled, contact their office - Medicare will keep rejecting claims until they enroll.
- Update the provider record in your PM system so future claims pull the right identifier.
How to prevent it
- Capture and verify the referring provider's NPI at scheduling or intake, not at billing.
- Validate referring NPIs against NPPES automatically in your PM or clearinghouse edits.
- For Medicare referrals, confirm PECOS enrollment before the visit when possible.
- Audit your referring-provider master list periodically for stale or duplicate entries.