Particular person NPI Quantity in Field 24J For Medicare Claims

When billing insurance coverage claims to Medicare, it may well get a bit difficult. Medicare has many guidelines which aren’t required by business insurance coverage firms. Since NPI numbers have been required on all claims in 2008 there was some confusion. All suppliers are required to have a person NPI quantity and a few are additionally required to have a gaggle NPI quantity. Then they should be entered within the applicable containers on the CMS 1500 declare kind.

Most often it’s necessary to have the rendering supplier’s particular person NPI in field 24J when submitting CMS 1500 types. Nonetheless, there are just a few instances when field 24J must be left clean as a way to stop denial of the declare. Ensure you file your claims accurately in accordance with Medicare’s guidelines.Most Medicare carriers require that field 24J be left clean if the billing supplier is a person supplier. In that case, the supplier’s particular person NPI, or kind I NPI can be entered in each field 24J and in field 33a. If this NPI is identical, Medicare requires that the NPI is NOT entered in 24J however that 24J is left clean.I actually have no idea why they do that, however it’s the rule. So in case you are submitting paper claims to Medicare for a person supplier who payments below simply a person NPI, or kind I NPI, and Medicare has been denying your claims, which may be why. If the supplier will get paid below a gaggle NPI you then would put the person NPI of the rendering supplier in field 24J.

Copyright 2010 – Michele Redmond – Options Medical Billing Inc

Leave a Reply

Your email address will not be published. Required fields are marked *