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Back  RFI # 631: Loop 2310B REF with NPI in NM1

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Submitter

Steve Scholze

Description

After May 23,2008, would it be compliant to require an REF segment, for TIN or SSN, in loop 2310B when the Rendering Provider's NPI is reported in NM109 of the same loop for professional claims (837p)?

Submitter Assigned Keywords

Render Provider NPI REF

Response

This is explicitly answered in the 004010X098 implementation guide. The Rendering Provider's Secondary Identification (REF) segment is
"Required when a secondary identification number is necessary to identify the entity." When an NPI is provided in NM109, the provider has been identified.

However, please refer to the CMS FAQ 5816 for further information on what (if any) additional identifiers may be used once the NPI is mandated for use. It is important to note: reporting the SSN or EIN at this level would not be for tax purposes.
Submission 2/18/2008
Status Date 5/5/2008
Status F - Final
Primary References
Document 004010X098A1
Section3.1
Page290
Set ID837
Secondary References
RFI ID 567
Document 004010X098A1
Section3.1
Page296
Set ID837
Loop2310B
Segment IDREF