Box 17a - Other ID#

  • Updated

Box Definition

Box 17a is the non-NPI ID of the referring provider and is a unique identifier or a taxonomy code. The qualifier indicating what the number represents is reported in the qualifier field to the immediate right of 17a. The qualifiers appropriate for identifying an ordering, referring, or supervising role are as follows:

  • DN -- referring provider
  • DK -- ordering provider
  • DQ -- supervising provider

In AveaOffice

AveaOffice will assign the appropriate qualifier for the referring provider based upon the role type assigned either on the Utilization Plan (U/R Required Services) or at the time attendance is recorded for Standalone Services. 

The taxonomy or Tax ID is not submitted as an Other ID on claim forms through AveaOffice. Instead, the NPI associated with the Rendering provider will be added in Box 17b.

Example of Referring Rendering Provider Role (same drop-down exists on Utilization Plan)

Referring Rendering Role.png

Referring provider qualifier as shown on CMS-1500 in Box 17a



EDI Loop/Segment

Loop 2310A, Segment NM101 (Qualifier), Segment NM103 (Last Name), and NM104 (First Name).

Related Articles

Box 17 - Name of Referring Provider or Other Source

Manage Rendering Providers

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