Question: What Is Box 32 On A HCFA?

What goes in box 17a on CMS 1500?

What is it.

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..

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 …

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!

How many blocks is a UB 04 claim?

Fields of the UB-04. There are 81 fields or lines on a UB-04. They’re referred to as form locators or “FL.” Each form locator has a unique purpose: Form locator 1: Billing provider name, street address, city, state, zip, telephone, fax, and country code.

What goes in box 32b on a HCFA?

What is it? Box 32b is used to indicate the non-NPI identification number of the service facility as assigned by the payer for the facility. Enter the 2-digit qualifier followed by the ID number.

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 many boxes does UB 04 have?

Understanding the UB-04 Fields. There are 81 fields (or lines) on a UB-04 form. These are referred to as form locators or “FL.” Each form locator has a unique purpose for the insurance carrier and provider so that they can communicate.

What is box 33a on a HCFA?

Box 33a is used to indicate the National Provider Identifier number of the Billing Provider.

What goes in box 33b on a HCFA?

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 is a HCFA Claim Form?

A HCFA 1500 form is used by the Health Care Financing Administration. It is used for health care claims. It is used to submit a bill or charge for health insurance coverage. This could be through Medicare, Champus, group health care, or other forms of insurance.

What is on a Superbill?

Essentially, a Superbill is an itemized list of all services provided to a client. … The Superbill will also contain additional information about the patient visit including practice information, CPT codes, ICD-10 codes, referring doctor and more.

What box does the CLIA number go in on a CMS 1500?

Clia number in CMS 1500 On each claim, the CLIA number of the laboratory that is actually performing the testing must be reported in item 23 on the CMS-1500 form. Referral laboratory claims are permitted only for independently billing clinical laboratories, specialty code 69.

ICD-10-CM codes are reported on UB-04 claims and CMS 1500 claims.

What are the five sections on a claim?

The HIPAA claim contains data elements that are structured in the five major sections of the HIPAA 837 transaction. These five major sections include: (1) provider information; (2) subscriber information; (3) payer information; (4) claim information; and (5) service line information.

What is clean claim?

A clean claim is defined by Medicare as a claim which has no defect, impropriety or special circumstance, including incomplete documentation that delays timely payment.

In what format are health care claims sent?

The 837P (Professional) is the standard format used by health care professionals and suppliers to transmit health care claims electronically. Review the chart below ANSI ASC X12N 837P for more information about this claim format.

What are the claim filing indicator codes?

Claim Filing Indicator CodePayer IDProvider ID09, WC, OF, CH, VA–11, 14, 15, MA, MB, MC-REQUIRED12, 16, CI, or HMREQUIRED-BLREQUIREDREQUIRED

How many numbers should be entered for the patient’s birth in block Item 3?

8Item 3 – Enter the patient’s 8-digit birth date (MM | DD | CCYY) and sex.

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 type of signature should be used in item number 31?

Box 31 indicates that the rendering provider has authorized the information on the claim form is correct. Enter “Signature on File,” “SOF,” or use the actual signature of the provider, including the credentials.