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Claim completion FAQ -- Indication of rendering physician billing number
Last Modified: 8/5/2022
Location: FL, PR, USVI
Business: Part B
Q: Where do I indicate a rendering physician’s billing number on my claim? A: If the practitioner rendering the service is part of a billing group, report the individual practitioner’s NPI in the 'Rendering Physician #' area (2310B loop, segments NM108 [XX] and NM109 [NPI], of the 837P electronic claim or Item 24J of the CMS-1500 paper claim form).
• The NPI is required for all rendering providers. If the NPI is missing, invalid, or submitted in the wrong area (e.g., valid NPI submitted in the upper, shaded portion of Item 24J), your claims will be rejected as unprocessable.
• Note: If submitting claims on the CMS-1500 paper claim form, report the NPI of the individual practitioner in the lower, non-shaded portion of Item 24J. Do not place any information in the upper, shaded portion of Item 24J or your claim will be rejected as unprocessable.
If you are an independent lab, ambulatory surgical center (ASC), independent diagnostic testing facility (IDTF), ambulance supplier, or a solo practitioner not associated with a billing group, a rendering provider identifier is not required in the Rendering Physician # area when billing services. Report the NPI of these types of providers in the 837P 2010AA Billing Provider loop, segments NM 108 (XX) and NM109 (NPI) of the electronic claim or Item 33a of the paper claim form.
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