BCBSRI requires providers to report the name and the Type 1 National Provider Identifier (NPI) of the ordering provider on the CMS-1500 claim form or electronic submission. This is applicable for laboratory, imaging, durable medical equipment, and home infusion providers. Here are the guidelines:

• The ordering/referring provider’s name should be reported in box 17, and the Type 1 NPI should be reported in box 17b.
• When the ordering provider is also the performing provider, as is often the case with in-office clinical labs (such as a urine dipstick), the performing provider should enter his or her information in boxes 17 and 17b.
• For electronic submitters, the Type 1 NPI of the ordering/referring provider must be in the 2310A Loop, NM109 segment.
• When a service is incident to the service of a physician or non-physician practitioner, the name of the person who performs the initial service and orders the non-physician service must appear in box 17.

Missing or incomplete information will result in a claim being rejected and sent back to the provider. Please see the full text of this policy.