What is Box 32 on a HCFA?
Box 32 is used to indicate the name and address of the facility where services were rendered. Enter the name, address, city, state, and ZIP code of the location.
What loop and segment is Box 32?
CMS-1500 Claim Form Crosswalk to EMC Loops and Segments
| CMS-1500 Form Item | CMS-1500 | EMC ANSI 837 Loop |
|---|---|---|
| 31 | Signature of Physician | 2300 |
| 32 | Service Facility Location | 2310C |
| 32A | Service Facility | 2310C |
| 32B | Service Facility Other ID# | N/A |
What is Box 32 B on CMS 1500?
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 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 electronic version of the CMS-1500?
The Form CMS-1500 is the standard claim form to bill MACs when a paper claim is allowed. The ANSI X12N 837P (Professional) Version 5010A1 is the current electronic claim version.
What are the differences between 4010 and 5010?
The 5010 standards will replace the existing 4010/4010A1 version of HIPAA transactions, which go back nearly a decade—an eternity in the IT world—and address many of the shortcomings in the current version, including the fact that 4010 does not support ICD-10 coding.
Does CMS-1500 require Box 32?
Not required by Medicare. Item 32 Form CMS-1500 (12-90) – Enter the name and address, and ZIP Code of the facility if the services were furnished in a hospital, clinic, laboratory, or facility other than the patient’s home or physician’s office.
Can you leave CMS box 32 as blank?
Enter name of service facility only if Service Location is different than Billing Provider name in box 33, otherwise leave box 32 blank. If this is included the service facility must be affiliated with the billing facility.
What to put on a CMS 1500 claim form?
For durable medical, orthotic, and prosthetic claims, the name and address of the location where the order was accepted must be entered (DME MAC only). This field is required. When more than one supplier is used, a separate CMS-1500 claim form shall be used to bill for each supplier.
Do you enter NPI identifier in Box 32?
If you bill with an NPI, enter the 14-digit service location identifier only if the services were rendered at a location other than that of the billing provider in box 33. Do not enter any other value in box 32a.
When do you enter your zip code on CMS 1500?
Effective for claims received on or after April 1, 2004, on the Form CMS-1500, only one name, address and ZIP Code may be entered in the block. If additional entries are needed, separate claim forms shall be submitted.