Know Your HIPAA Claims
HIPAA 837 Billing Instructions for all Providers
(For further instruction please see the 837 Companion Guide)
When using software other than EDI Claims Link for Windows:
LOOP 2010AA – Billing Provider Information
| NM1*85 (85 indicates this is the billing provider information & is the only valid value) |
NM108 = XX (XX indicates this is NPI data) |
NM109 = Agency’s NPI (Your billing NPI number) |
The agency’s NPI is required so that a valid match can be made against the information which you submitted to ValueOptions. |
N3 |
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This should be the billing address for the agency, (the location to which vouchers/checks will be mailed) |
N4 |
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City, State Zip for the preceding address. |
REF |
REF01 = EI |
REF02 = Agency Tax ID |
Tax ID information is required for tax purposes. |
Service Location must include the address where services were rendered.
LOOP 2310D – Service Facility Location
| NM1*FA | NM108 = XX This is not required, but if it is supplied, the value MUST be “XX” |
NM109 = Agency NPI This is not required, but if it is supplied, the value MUST be the agency NPI |
Only the Agency NPI is a valid value. Tax ID or SSN values which might have been carried in this segment are no longer options |
N3 |
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This should be the address where services for this claim were rendered. |
N4 |
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City, State Zip for the preceding address. |
Rendering Provider must include the Agency NPI, XX qualifier, and taxonomy code:
LOOP 2310B – Rendering Provider
| NM1*82 | NM103 – Rendering practitioner’s last name followed by a comma, followed by one space, then the licensure level | This information is required to determine which fee schedule should be applied for the professional services contained on the claim. EXAMPLE: |
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NM1*82 |
NM108 = XX |
NM109 = Agency’s NPI |
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PRV |
PRV02 = ZZ |
PRV03 = Taxonomy for the rendering practitioner |
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