Thursday, June 24, 2010

What is ID qualifier in CMS 1500

The other ID number of the referring provider, ordering provider, or other source should be reported in 17a in the shaded area. The qualifier indicating what the number represents should be reported in the qualifier field to the immediate right of 17a. The NUCC defines the following qualifiers, since they are the same as those used in the electronic 837 Professional 4010A1:

• 0B – State license number

• 1B – Blue Shield provider number

• 1C – Medicare provider number

• 1D – Medicaid provider number

• 1G – Provider UPIN number

• 1H – CHAMPUS identification number

• EI – Employer’s identification number

• G2 – Provider commercial number

• LU – Location number

• N5 – Provider plan network identification number

• SY – Social Security number (The Social Security number may not be used for Medicare)

• X5 – State industrial accident provider number

• ZZ – Provider taxonomy – A list of the valid Taxonomy codes

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