LEEDer Group Inc.
8508 North West 66th St.
Miami, Florida 33166 USA

Phone Toll-free: 866.814.0192
Fax Toll-free: 866.818.0373
E-mail Address: orders at LEEDerGroup.com

2008-04 Provider Alert Provider ID info in Block 24k of CMS-1500

Part B Carrier

South Carolina General Information
Supplying Correct Provider Identification Information in Block 24K of CMS-1500 Form

We continue to receive claims in which Block 24K is being filled out incorrectly on the CMS-1500 form and/or its electronic equivalent.

A reminder: When filling out the CMS-1500 form, please remember to enter the Provider Identification Number (PIN) of the performing provider of service in Block 24K if the provider is a member of a group practice. When several different providers of service or suppliers within a group are billing on the same CMS-1500 form, or electronic equivalent, show the individual PIN of each performing provider in the corresponding line item. In the case of a service provided incident to the service of a physician or non-physician practitioner, when the person who ordered the service is not supervising, enter the PIN of the supervisor in Block 24K.

If Block 24K on the CMS-1500 form and/or its electronic equivalent is not filled our correctly, your claim will deny.

NOTE: UPINs are not appropriate identifiers for Block 24K.

A Medlearn Matters Special Edition article, SE0529, offers indepth information on Block 24K and other areas of the CMS-1500 form requiring provider identification information. To access this article, click here.

If you have any questions, please contact the Provider Contact Center at 1-866-238-9654.