Box 17a - Other ID#

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 Kipu RCM

The RCM will assign the appropriate qualifier for the referring provider based on the role type designated on the Utilization Plan (U/R Required Services) or when attendance is recorded for Standalone Services on the Attendance Calendar. However, these fields are only available with additional configuration by support. Please reach out to [e-mail] for assistance.

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

EDI Loop/Segment

Loop 2310A, Segment NM101 (Qualifier), Segment NM103 (Last Name), and NM104 (First Name). For additional information on loops and segments, click here.