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N264 Remark Code: Ordering Provider Name Invalid

N264 means the name of the ordering provider, the clinician who ordered the test, item, or service, was missing, incomplete, or invalid on the claim. Payers match it against the ordering NPI and their enrollment records.

Quick facts

Code
N264 (RARC N264)
Status
Active In use since December 2, 2004.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The supplier or performing provider must correct the ordering information. The patient is not liable for this adjustment.
Official description
Missing/incomplete/invalid ordering provider name.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N264 means

Many services are performed by one provider on the order of another. A lab runs tests a physician ordered; a DME supplier delivers equipment a clinician prescribed; an imaging center performs a scan on referral. The claim for that service must identify who ordered it. N264 means the ordering clinician’s name failed the payer’s edit.

The remark often appears with CARC 16. Some payers compare the name with enrollment data character by character, so what looks like a small formatting difference can be enough to deny.

Common causes

  • The order came in with a nickname or abbreviated first name that doesn’t match the clinician’s registered name.
  • The ordering clinician was a nurse practitioner or physician assistant, but the supervising physician’s name was entered, or the reverse.
  • Box 17 carried the name without the DK qualifier, or with a referring qualifier when the payer wanted an ordering one.
  • Staff typed the name from a handwritten order and misspelled it.
  • The ordering clinician changed their legal name and your referral database still has the old one.

How to fix it

  1. Pull the order or prescription and identify exactly who signed it.
  2. Look up that clinician in NPPES using the NPI on the order, and copy the name as registered.
  3. Correct box 17 (with the DK qualifier) or the ordering provider fields in your 837P, keeping the name and NPI consistent.
  4. Resubmit as a corrected claim with frequency code 7 in box 22 and the original claim number.

How to prevent it

Look up ordering clinicians by NPI instead of typing names from orders. Many practice systems can search NPPES data so the registered name populates automatically. For DME and lab work, confirm before billing that the ordering clinician is eligible to order the service; the authorization and referral denials guide covers related front-end checks.

Codes that may appear with N264

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): Missing or invalid claim information; N264 isolates the ordering provider's name.
  • CO-184 (The prescribing/ordering provider is not eligible to prescribe/order the service billed.): Used when the ordering provider exists but is not eligible to order the service billed.
  • N265 (Missing/incomplete/invalid ordering provider primary identifier.): Concerns the ordering provider's NPI instead of the name.
  • N575 (Mismatch between the submitted ordering/referring provider name and the ordering/referring provider name stored in our records.): Specifically flags a mismatch between the submitted ordering or referring name and the payer's stored name.
  • N285 (Missing/incomplete/invalid referring provider name.): The name problem for a referring provider rather than an ordering one.
  • N544 (Alert: Although this was paid, you have billed with a referring/ordering provider that does not match our system record.): An alert that a paid claim carried a referring or ordering provider that does not match payer records.

N264 FAQ

Where does the ordering provider name go on a CMS-1500?

In box 17, preceded by the DK qualifier that identifies the person as the ordering provider. The NPI goes in box 17b.

Which claims need an ordering provider?

Typically claims for services performed on someone else's order, such as DME and supplies, clinical lab tests, and diagnostic imaging. Payer rules vary by service type.

How should the name be formatted?

Enter the ordering clinician's name as registered with the NPI, in the order your form or 837 fields expect, without credentials or titles in the name fields.