Type 1 Attending Provider Required on Institutional Claims in HIPAA Version 5010

March 30, 2012

In HIPAA Version 5010, you are required to include the Attending Provider on all institutional claims other than non-scheduled transportation claims. All providers, including PNMI providers, must use a Type 1 NPI in this field to avoid rejection. The Attending Provider does not need to be enrolled in MaineCare.

Previously, listing the Attending Provider (the individual who has overall responsibility for the patient’s medical care and treatment reported in the claim) was only required for inpatient claims (ANSI Loop 2310A on the 837I or Field Number 76 on the UB-04).