Status code 562 means one of the NPIs on the claim is missing, invalid, or not what the payer has on file. The entity code sent with it tells you which one: 85 is the billing provider, 82 the rendering provider, DN the referring provider and 77 the service location.
What does status code 562 mean?
X12 claim status code 562 reads: “Entity’s National Provider Identifier (NPI). Usage: This code requires use of an Entity Code.” It is published in the X12 Claim Status Codes list (opens in a new tab). The entity code is required, and it is the key to the fix.
On the raw 277CA it appears in the STC segment, for example STC*A7:562:85: the claim status category, then the status code, then the entity code when one is required. A rejected claim never entered the payer’s claims system, so there is nothing to appeal: you fix the data and send the claim again.
Common causes
| Cause | What to check |
|---|---|
| Typo or wrong NPI in the provider setup | The NPPES NPI Registry |
| Individual (type 1) NPI used where the group (type 2) NPI belongs, or the reverse | Billing provider vs. rendering provider fields |
| Rendering provider not enrolled with the payer under this group | Payer enrollment records |
| Referring provider NPI missing when the payer requires one | Referral and the payer’s rules |
| NPI deactivated or not yet active | NPPES status |
How to fix it
- Read the entity code to find which provider the rejection is about.
- Look up that NPI in the NPPES NPI Registry (opens in a new tab) and compare the name, type and taxonomy.
- Confirm the provider is enrolled with the payer under this group and tax ID.
- Correct the provider file in your practice management system, then resubmit as a new claim.
How to prevent it
- Keep one provider file with NPIs, taxonomy, tax IDs and enrollment dates.
- Do not bill a new provider under a payer until enrollment is confirmed.
- Recheck NPPES data when a provider joins, leaves or moves.
Frequently asked questions
What does entity code 85 mean with status 562?
The billing provider NPI, usually the group’s type 2 NPI, is the problem.
Can a valid NPI still be rejected?
Yes. The NPI can be valid in NPPES but not linked to your group or enrollment with that payer.
Related claim rejection guides
- 277CA claim acknowledgment: how to read a rejection
- Status 33: subscriber and subscriber ID not found
- Status 116: claim submitted to incorrect payer
- Status 128: Entity’s tax ID
- Status 145: Entity’s specialty/taxonomy code
- Status 496: submitter not approved for electronic claims
- “This code requires use of an Entity Code”
Status code wording is quoted from the X12 Claim Status Codes list (opens in a new tab) at the time of writing. Clearinghouse reports may show the same codes with slightly different text.
Provider data causing rejections?
We keep provider NPIs, taxonomy and enrollment in sync, and our credentialing team closes the gaps.