Disposition Code 56 (MBI/HICN Mismatch)

20.3.3.7 - Disposition Code 56 (MBI/HICN Mismatch) (Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18) Specific to new Medicare Beneficiary Identifier (MBI) processing, disposition code 56 can come with any of the following three error codes: 1. With Error Code 5060 - MBI entered is not found on the CWF file. 2. With Error Code 5061 - HICN entered is not found on the CWF file. 3. With Error Code 5062 - HICN and Submitted MBI combination on the claim do not belong to the same beneficiary. A/B MACs shall return the provider claims as unprocessable. When returning these claims as unprocessable, the shared processing system shall use Claim Adjustment Group Code (Group Code) CO – Contractual Obligation, Claim Adjustment Reason Code (CARC) 16 - Claim/service lacks information or has submission/billing error(s) which is needed for adjudication. Do not use this code for claims attachment(s)/other documentation. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.) Note: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present, and RARC N382: Missing/incomplete/invalid Medicare beneficiary identifier.