5010 Data Entry Guidelines

Tips for entering physician and facility information for ANSI 837 claims

To easily navigate this article, use the links provided below. At the end of each section, click "Back to Top" to return to this menu.

Physician/Facility Library Data Entry

Pay-To Provider

Facility

Referring Provider

Rendering Provider

Ordering Provider

Supervising Provider

Patient Tab

Claim Tab

Chiropractic

Secondary Claims

Misc Changes

Physician/Facility Library Data Entry

Billing Provider

P.O Box Address - not allowed

Required: 9 Digit Zip Code (no dashes)

Situational: Additional ID Numbers allowed

0B  - State License Number

1G - UPIN Number (Payer-assigned Number)

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Pay-To Provider

Pay-To Provider may use a P.O. Box address. It is entered as part of the Billing Provider entry in the Physician/Facility Library. Click Pay to Address to begin entering data.

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Facility

Required: 9 Digit Zip Code (no dashes)

If Place of Service is 11, do not enter Facility information unless different than Billing provider information or unless required by payer. For other POS codes, contact your insurance payer for guidelines.

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Referring Provider

No Taxonomy codes allowed

Situational: Additional ID Numbers allowed

0B - State License Number

1G - UPIN Number

G2 - Commercial Number

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Rendering Provider

Situational: Additional ID Numbers allowed

0B - State License Number

1G - UPIN Number

G2 - Commercial Number

LU - Location Number

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Ordering Provider

Situational: Additional ID Numbers allowed

0B - State License Number

1G - UPIN Number

G2 - Commercial Number

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Supervising Provider

Situational: Additional ID Numbers allowed

0B - State License Number

1G - UPIN Number

G2 - Commercial Number

LU - Location Number

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Patient Tab

Signature Source field

Leave blank or select 'P' (usually left blank)

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Claim Tab

Ambulance

Pick-up and drop-off info if POS = 41 or 42

Ambulance transport reason (IRTX) no longer used

New loops: 2310E is pick-up info

2310F is drop-off info

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Chiropractic

Nature of Condition and Acute Manifestation Date - only fields used

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Secondary Claims

Allowed/Approved Amounts are no longer used

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Misc Changes

Supervising provider loop change from 2310E to 2310D

CMN - Loop 2400 CR5-01 thru CR5-18 DELETED

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