Quick Answer: What Goes In Box 17a On CMS 1500?

What does the ZZ qualifier mean?

rendering provider taxonomy codesRENDERING ID QUALIFIER Enter the qualifier indicating what the number reported in the shaded area of 24J represents – 1D or G2 for IHCP LPI rendering provider number, or ZZ or PXC for rendering provider taxonomy codes.

(Required, if applicable.) …

ZZ and PXC are the qualifiers that apply to the provider taxonomy code..

What is a CMS 1500?

The CMS-1500 form is the standard claim form used by a non-institutional provider or supplier to bill Medicare carriers and durable medical equipment regional carriers (DMERCs) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of …

What is a CMS 1500 form how is it used for billing?

Form CMS-1500 is the standard paper claim form used to bill an insurance for rendered services and supplies. It provides information about the client, their corresponding insurance policy, and their diagnosis and treatment.

What box does the taxonomy code go in on a HCFA 1500?

TAXONOMY PLACEMENT ON A CLAIM CMS 1500 PAPER SUBMISSION: Rendering – Box 24i should contain the qualifier “ZZ.” Box 24j (shaded area) should contain the taxonomy code. Billing – Box 33b should contain the qualifier “ZZ” along with the taxonomy code.

How many diagnoses can be reported on the CMS 1500?

diagnoses can be reported in item 21 on the CMS-1500 paper claim (02/12) (see the 2015 PQRS Implementation Guide) and up to 12 diagnoses can be reported in the header on the electronic claim. Only one diagnosis can be linked to each line item.

What goes in box 19 on a CMS 1500?

Box 19 If Applicable Reserved for Local Use – Use this area for procedures that require additional information, justification or an Emergency Certification Statement. This section may be used for an unlisted procedure code when explanation is required and clinical review is required.

How do you fill out a CMS 1500?

Enter the patient’s mailing address and telephone number. On the first line enter the street address; the second line, the city and state; the third line, the ZIP code and Page 2 Instructions on how to fill out the CMS 1500 Form telephone number. If Medicare is primary, leave blank.

Are taxonomy codes required on claims?

Answer: Medicare does not require a taxonomy code to process a claim; however, we will verify that the taxonomy code is valid by comparing it with the latest National Uniform Claim Committee (NUCC) Healthcare Provider Taxonomy Codes (HPTC) code set if it is submitted on the claim.

What goes in box 32b on CMS 1500?

Box 32b 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 32B:’ under the ‘HCFA-1500/UB-92’ tab of the Payers screen (of the payer to whom this claim is being sent).

Where does the NPI number go on CMS 1500?

Where do I put my NPI number on the CMS 1500? Enter your NPI number in: The non-shaded area of Box 24J. Box 33a.

Which are preprinted in Block 21 of the CMS 1500 claim?

Diagnosis pointer letters A-L are preprinted in Block 21 of the CMS -1500 claim to allow for entry of _____codes, and they are reported in Block 24 E. You just studied 27 terms!

What goes in box 24j on HCFA 1500?

What is it? Box 24j Shaded is used to identify the non-NPI if indicated by a qualifier in 24i. Box 24j displays the NPI of the Rendering Provider.

What is the diagnosis pointer on a CMS 1500?

Diagnosis code pointers are used to indicate the appropriate order of importance in relation to the service being performed. The first pointer designates the primary diagnosis for the service line. Remaining diagnosis pointers indicate declining level of importance to service line. website.

What is a g2 qualifier?

The purpose of qualifier G2 being utilized in field 32b is to. indicate that the ID is a non-NPI number. The G2 qualifier on a. paper claim (field 32b) should only be used to identify atypical. providers who have not obtained a NPI and are submitting with a.

What are six items needed to reference when completing the CMS 1500?

After the procedure was completed, what are six items needed to reference when completing the CMS-1500 Health Insurance Claim Form?…Patient health record.patient insurance card information.encounter form.insurance claim processing guidelines.patient registration form.precertification information.