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Formal vs. Informal Help Informal Formal


Craig Keene


As a healthcare payer, we have a provider who cannot get an NPI. If the provider acquires an Other Entity ID that meets the Luhn-10 algorithm, can we accept that value in the NM1 segment with the XX qualifier? If not, where would you recommend that value be placed within the transmission?


It is not compliant with the guide to submit an Other Entity ID with the XX qualifier. The qualifier XX is to be used to identify NPIs exclusively. If a provider cannot obtain a NPI then they should submit the other ID as the billing provider secondary identification (2010BB REF02) with a G2 qualifier.
Submission 5/26/2016
Status Date 7/5/2016
Status F - Final
Primary References
Document 005010X222A1