N264: Missing/incomplete/invalid ordering provider name
The claim did not include the name of the provider who ordered the service, or the name submitted does not match a valid enrolled provider.
Corrective actions
- 1
Confirm the ordering provider on the referral or order
Pull the original order or referral and verify the exact name of the ordering provider as enrolled with the payer.
- 2
Resubmit with the corrected ordering provider name
Add the correct ordering provider name to the claim, matching the identifier submitted in the related NPI field, and resubmit.
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Retrieved 2026-07-18.
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DenialPath provides billing and administrative guidance based on published CMS and X12 sources. It is not medical advice, not a coverage determination, and not a guarantee of payment. NCCI and MUE edits are republished quarterly and payer policies vary by contract. Always confirm against the payer's own current policy before submitting or appealing.