Box 19 - Additional Claim Information (Designated by NUCC)

Box Definition 

Box 19 is used to identify additional information about the patient's condition or the claim.

As of January 1, 2023, Arizona Medicaid requires Behavioral Health providers to add participating provider information when the providers rendering the services are different from the providers on the service line.

In Kipu RCM

Let's review how to update Box 19 in the RCM!

• Box 19 will be filled out based on the selection for recording attendance under the Additional Providers field. To appear in Box 19, eligible providers must have the Is Medicaid Registerable portion of their profile toggled on. For additional information on configuring the rendering provider profile, click here. 
• Box 19 can be altered on a claim before submitting it using our Claim Edits feature. To learn more about this feature, click here.

EDI Loop and Segment

Loops 2300/2310a-d, Segment NTE/PWK/REF 01/REF 02. For additional information on loops and segments, click here.