In the past, we have communicated the importance of submitting a rendering NPI when any of the following situations apply to your medical practice:

• There is more than one rendering physician within the practice
• You are considered a Multi-specialty Group Practice
• You obtained a Type I (Individual) NPI and a Type 2 (Organizational) NPI

If you are currently receiving the following Reject message:

Please be aware that this Reject message means that "The NPI submitted on the claim to identify who provided the services is identified in our files as a billing entity, not a rendering provider." To rectify the above error message, the NPI of the provider who rendered the services should be populated in Loop 2310B – Data Element NM109, which is equivalent to Box 24J on the CMS-1500 claim form.

NOTE: You must continue to include the Billing NPI in Loop 2010AA – Data Element NM109. This Data Element is equivalent to Box 33A in the CMS-1500 Form.

If you are currently receiving the following Warning message:

Please be advised that this Warning message alerts you that "If the NPI billing provider record is NOT established as 'valid as rendering,' then the claim rendering provider loop (2310B) is required." In this situation, you must include the rendering provider’s NPI in Loop 2310B – Data Element NM109. This Data Element is equivalent to Box 24J on the CMS-1500 claim form.

When filing claims, it is imperative, to include the rendering NPI (Type 1) in the rendering field (2310B Loop) and the billing NPI (Type 2) in the billing field (2010AA). The appropriate billing and rendering NPI must be entered properly to avoid claim rejection(s) and ensure proper payment.

If you have any questions about these edits, please contact our Electronic Commerce Center at (800) 746-4614.