CMS-1500 box 24J

Box 24 on the CMS-1500 has six service lines, and each line is split horizontally: the top half is shaded and the bottom half is not. Column J holds the rendering provider, the person or company, such as a laboratory, that performed or supervised the care. The National Uniform Claim Committee instructions put the 10-digit NPI in the unshaded half and any non-NPI identifier, up to 11 characters, in the shaded half. The qualifier that says what kind of non-NPI number it is goes in the shaded part of 24I: 0B for a state license, 1G for a UPIN, G2 for a payer’s own provider number, LU for a location number, or ZZ for a taxonomy code. When a locum tenens physician substitutes, that physician’s information goes here.

NUCC says to report 24I and 24J only when the rendering provider differs from the billing provider data in items 33a and 33b. Medicare’s manual adds its own rules. It asks for the rendering provider’s NPI in the lower unshaded portion of 24J, and since May 23, 2008 the shaded portion is not reported. For a service billed incident to a physician or non-physician practitioner where the person who ordered it is not the one supervising, the supervisor’s NPI goes in 24J.

The mistake is treating 24J as a copy of 33a. A group NPI in the rendering field, a billing NPI where an individual one belongs, or an individual who is not enrolled with the payer under that group can all stop the line, and the fix is an enrollment and data question rather than a coding one. Confirm that every rendering NPI on the claim is linked to the billing group with that payer before the first claim goes out.