Section title: Requests for Interpretation
RFI #
1327
Medicare CCN
Description

The Medicare CCN (CMS Certification Number or Medicare Provier ID) is no longer available in the 5010. It was reported as REF 1C in the 2010AA Loop - Billing Provider Tax Identification.

We used this information to identify units within a hospital, for example to tell the skilled nursing unit patients from the acute unit patients.

In the 5010 the REF 1C is not available. What is the alternative?

RFI Response

The Payer assigned Billing Provider Identifier is located in destination payer Loop ID 2010BB (Billing Provider Secondary Identification) REF Segment of the 005010 institutional 837. This REF segment should only be used when the Billing Provider Loop ID 2010AA does not contain the Billing Provider NPI (i.e. Atypical).

RFI Recommendation

The Billing Provider Taxonomy Code (Loop ID 2000A, PRV Segment) could be utilized to identify the specific unit within the hospital that is being reported.

DOCUMENT ID
005010X223A1