P B F
1 Fev, 2019

Claim submissions with taxonomy code

Effective 1 de abril, 2019, BCBSRI will require the provider taxonomy code to be submitted on all claims.

Professional requirements (CMS-1500):

- Paper claims, place in box 33b proceeded with the ZZ qualifier for the billing level

- Paper claim, place in the shaded portion in box 24J

- Paper claim, place qualifier ZZ in box 24I

 

UB-04 Claims

Institutional requirements (UB04):

• Billing Taxonomy

- Paper claim, box 57

• Rendering Taxonomy

- Not required

 

Electronic Claims Looping

 

837I

2000A Loop Billing Provider

PRV Segment- Billing provider specialty information

Example               PRVBIPXC282NR1301X~

 

 

2310A Loop Attending Provider name

PRV segment- Attending provider specialty Information

Example               PRVATPXC208D00000X~

 

 

837 P

2000A Loop Billing Provider

PRV Segment- billing Provider specialty information

Example               PRVBIPXC207Q00000X~

 

 

2310B- Rendering Provider Claim level

PRV segment- Rendering Provider Specialty information

Example               PRVPEPXC1223G0001X~

 

 

2420A Rendering Provider- Line level

PRV segment- Rendering Provider Specialty Information

Example               PRVPEPXC208D00000X~