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Data Element
CLT213
CLT.003.213
Definition | The NPI of the health care professional who delivers or completes a particular medical service or non-surgical procedure. The Servicing Provider NPI Number is required when rendering provider is different than the attending provider and state or federal regulatory requirements call for a "combined claim" (i.e., a claim that includes both facility and professional components). Examples are Medicaid clinic bills or critical access hospital claims. |
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Size | X(10) |
FLF Start Position | 318 |
FLF Stop Position | 327 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be 10 digits 2. Value must have an associated Provider Identifier Type equal to "2" 3. Conditional 4. If Type of Claim (CLT.002.052) not in [3,C,W], then value must match Provider Identifier (PRV.005.081) 5. NPPES Entity Type Code associate with this NPI must equal �1� (Individual) 6. Value must exist in the NPPES NPI data file |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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CIP261 | CIP.003.261 | SERVICING-PROV-NPI-NUM | CIP00003 | CLAIM-LINE-RECORD-IP |
COT190 | COT.003.190 | SERVICING-PROV-NPI-NUM | COT00003 | CLAIM-LINE-RECORD-OT |