Primary payer information missing on a secondary claim
You billed this payer as secondary, but the claim does not show who the primary payer was or what it paid.
Usual causes
- Secondary claim sent without the primary payer's payment and adjustment details (loop 2320 and 2430).
- Paper claim: the primary EOB was not attached or was unreadable.
- Primary payer information entered in the wrong fields.
The fix
Resend the secondary claim with the primary payer's name, paid amount, allowed amount and adjustment codes from its remittance, or attach a readable copy of the primary EOB.
Appeal or corrected claim?
Corrected claim with the primary payment details.
Deadline to watch
Secondary timely filing limit, often counted from the primary remittance date.
Exact limits are in your payer contract or provider manual. When in doubt, send the correction or appeal this week.
Often seen together
The payer believes another plan is primary and needs its payment information. Bill the primary first, or have the patient update coordination of benefits.
MA04 in short
What does MA04 mean?
You billed this payer as secondary, but the claim does not show who the primary payer was or what it paid. The official X12 text reads: "Secondary payment cannot be considered without the identity of or payment information from the primary payer. The information was either not reported or was illegible."
What usually causes a MA04 denial?
Secondary claim sent without the primary payer's payment and adjustment details (loop 2320 and 2430). Paper claim: the primary EOB was not attached or was unreadable. Primary payer information entered in the wrong fields.
How do I fix MA04?
Resend the secondary claim with the primary payer's name, paid amount, allowed amount and adjustment codes from its remittance, or attach a readable copy of the primary EOB.
Should I appeal MA04 or send a corrected claim?
Corrected claim. Corrected claim with the primary payment details.
What deadline applies to MA04?
Secondary timely filing limit, often counted from the primary remittance date.