Section title: Requests for Interpretation
Zip Code Examples in 837P

N403 in 2010AA and 2310C in x222 (5010 837P) both have the note, "When reporting the ZIP code for U.S. addresses, the full nine digit ZIP code must be provided."

The TR3 examples given for both 2010AA and 2310C segments is:


The ZIP code should be nine digits, not five.

The 837I and 837D have the same issue.

Also, what formatting should be used for the nine digit zip code? Nine digits, or the five-dash-four format?

RFI Response

The use of the zip+4 for just the billing provider and the service location was intentional. This was to help in identification of various parts of an organization when they shared an NPI. The zip+4 is not needed for the other loops. The example incorrectly shows a five digit zip code. These examples will be corrected in a future version of the Guides. When reporting a nine digit zip code it must be in the format of 123456789, without a dash.