Box 24i - ID Qualifier

Box Definition

Box 24i is used to show the ID qualifier for the rendering provider information in the shaded area of Box 24j.

The qualifiers will indicate the non-NPI number being reported. The following qualifiers can be used:

• 0B - State License Number 
• 1G - Provider UPIN Number 
• G2 - Provider Commercial Number 
• ZZ - Provider Taxonomy

In AveaOffice

To change the ID qualifier on the claim form:

1. Navigate to Practice Admin > Rendering Providers.

2. Select the rendering provider to add identification numbers.

3. Add a Scheduled Change Set for an effective date, or edit the baseline to add identification numbers.

4. Click Save.

5. Navigate to Management Center > Claim Rules.

6. Select Claim Line Item Rule. 

7. Create a Claim Line Item Rule for professional claim types with the behavior "Set Secondary Provider ID to:" and select the appropriate identification number.

8. Click Create.

EDI Loop/Segment

0B, 1G, and G2

• Loop 2310B, Segment REF01