How do I fix or resolve code 140?

Verify the patient's member ID, name, and date of birth against the insurance card and a government-issued ID to ensure the claim was submitted with the correct information. Run a 270/271 eligibility transaction with the exact member ID and name to confirm the patient is enrolled and identify any name or ID discrepancies in the payer's system. If the member ID or name was entered incorrectly on the claim, correct the information in the practice management system and resubmit the claim with the accurate member ID and patient name. If the patient's name changed (e.g., marriage, divorce), contact the payer to update the enrollment record and resubmit the claim with the corrected name once the payer confirms the update. If the patient is a dependent, verify the subscriber's name and ID are correctly entered in the correct loops of the 837 transaction (subscriber loop 2010BA, patient loop 2010CA).

140Denial CodeGeneral Adjustment

Code 140

Problem Description

Patient/Insured health identification number and name do not match.

Root Cause

The patient or insured health identification number and name do not match. The payer's eligibility system cross-references the member ID and the patient name on the claim against their enrollment database, and the combination does not match. This typically results from a transposed digit in the member ID, a misspelled patient name, a name change not updated in the payer system, or a subscriber vs. patient name mismatch when the patient is a dependent.

Resolution Steps

1Verify the patient's member ID, name, and date of birth against the insurance card and a government-issued ID to ensure the claim was submitted with the correct information.
2Run a 270/271 eligibility transaction with the exact member ID and name to confirm the patient is enrolled and identify any name or ID discrepancies in the payer's system.
3If the member ID or name was entered incorrectly on the claim, correct the information in the practice management system and resubmit the claim with the accurate member ID and patient name.
4If the patient's name changed (e.g., marriage, divorce), contact the payer to update the enrollment record and resubmit the claim with the corrected name once the payer confirms the update.
5If the patient is a dependent, verify the subscriber's name and ID are correctly entered in the correct loops of the 837 transaction (subscriber loop 2010BA, patient loop 2010CA).

EHR Documentation Note

Claim denied 140 — member ID/name mismatch; verified patient demographics against insurance card, corrected member ID or name, and resubmitted claim.

Preventative Action

Scan insurance cards at check-in and use a 270/271 eligibility check to validate the member ID and name match before claim submission; update patient demographics in real-time.

Related Codes in General Adjustment

Deductible Amount

Coinsurance Amount

Co-payment Amount

The procedure/revenue code is inconsistent with the patient's age. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.

This directory provides reference information only and does not constitute official legal, medical, or financial billing advice. Always consult the payer's official remittance advice and current coding guidelines.