What goes in box 33b on a HCFA 1500?
non-NPI identity of the Billing provider
Box 33b contains the non-NPI identity of the Billing provider. The source for the actual non-NPI value is the text entered into the field labeled ‘Box 33B:’ under the ‘HCFA-1500/UB-92’ tab of the Payers screen (of the payer to whom this claim is being sent).
What is a qualifier in box 17?
What is it? Box 17 identifies the name of the referring provider on the claim. Enter the applicable qualifier to the left of the vertical dotted line to identify which provider is being reported.
What is Box 33b?
Box 33b is used to indicate a payer-assigned identifier of the Billing Provider. Some payers require the provider’s taxonomy code be listed in Box 33b.
What qualifier should be listed in block 17 for a referring provider?
The qualifiers appropriate for identifying an ordering, referring, or supervising role are as follows: • DN — referring provider • DK — ordering provider • DQ — supervising provider • Enter the qualifier to the left of the dotted vertical line on item 17.
What is ZZ qualifier?
ZZ and PXC are the qualifiers that apply to the provider taxonomy code. The taxonomy code includes 10 alphanumeric characters. Taxonomy may be needed to establish a one-to-one NPI/LPI match if the provider has multiple locations. Required when applicable and for any waiver-related services. (Required if applicable.)
What is Box 32b in CMS 1500?
Box 32a: If required by Medicare claims processing policy, enter the National Provider Identifier (NPI) of the service facility. Box 32b: If required by Medicare claims processing policy, enter the legacy Provider Identification Number (PIN) of the service facility preceded by the ID qualifier 1C.
What goes in box 17 on HCFA?
Box 17 on the HCFA populates from information found in the Demographics tab, under Referring Doctor. The fields Referring Dr. First Name and Referring Dr. Last Name will be used, and the identifier DN will be applied.
What is Box 17a in CMS 1500?
Box 17a is the non-NPI ID of the referring provider and is a unique identifier or a taxonomy code. The qualifier indicating what the number represents is reported in the qualifier field to the immediate right of 17a. The available qualifiers are: 9F – Medicaid Montana Passport. 0B – State License Number.
What information goes in box 32 on CMS-1500?
Item 32 Form CMS-1500 (12-90) – Enter the name and address, and ZIP Code of the facility if the services were furnished in a hospital, clinic, laboratory, or facility other than the patient’s home or physician’s office.
What goes in box 24c on HCFA?
24c. EMG-Emergency Enter a Y in the unshaded area of the field. If this is not an emergency, leave this field blank. 24d.
What is Box 17a in CMS-1500?
What is a ZZ qualifier for CMS 1500?
ZZ and PXC are the qualifiers that apply to the provider taxonomy code. The taxonomy code includes 10 alphanumeric characters. Taxonomy may be needed to establish a one-to-one NPI/LPI match if the provider has multiple locations. Required when applicable and for any waiver-related services.
How do I enter 33B on the CMS-1500 form?
This is a required field. Item 33b Form CMS-1500 (08-05) – Enter the ID qualifier 1C followed by one blank space and then the PIN of the billing provider or group. Effective May 23, 2007, and later, 33b is not to be reported.
What are the two-digit qualifiers for the revised 1500 claim form?
Fields 32b and 33b do not have a separate area for the qualifiers, but the qualifier should still be the first two digits entered. These two-digit qualifiers should be used as appropriate in fields 17a, 24I, 32b and 33b of the revised 1500 claim form. SY Social Security number (This may not be used for Medicare.)
When is 33B no longer required to be reported?
Effective May 23, 2007, and later, 33b is not to be reported. Suppliers billing the DME MAC will use the National Supplier Clearinghouse (NSC) number in this item.
What is box 33B used for?
Box 33b is used to indicate a payer-assigned identifier of the Billing Provider. Some payers require the provider’s taxonomy code be listed in Box 33b.