Does the guide allow multiple identifiers to be sent for the 2310B Rendering Provider?
We are sending the provider's NPI in 2310B NM109. Multiple payers are indicating that we also need to send the 2310B REF: 0B State License Number.
We are not certain that both can be sent. Our interpretation of the 2310B NM109 is that the NPI is required as we are past the NPI implementation date.
The 2310B REF Situational rule states “required prior to NPI implementation" or "after the mandated Implementation Date when the [2310B] NM109 is not used...If not required by this implementation guide, do not send."
The situational rule of the 2310B REF seems to indicate the REF segment should not sent due to the required presence of the 2310B NM109.
The Situational Usage Rule of the Loop 2310B REF – Rendering Provider Secondary Identification segment reads:
“Required prior to the mandated HIPAA National Provider Identifier (NPI) implementation date when an identification number other than the NPI is necessary for the receiver to identify the provider.
OR
Required on or after the mandated NPI Implementation Date when NM109 in this loop is not used and an identification number other than the NPI is necessary for the receiver to identify the provider.
If not required by this implementation guide, do not send.”
The NPI was adopted and became effective, i.e. mandated, May 23, 2007. Now, only the second part of the Situational Rule applies. This requirement explicitly states that the 2310B REF segment must not be sent if the NPI is sent in the 2310B Loop NM109.