In an ongoing effort to better align with industry standards of practice, the Office of Workers’ Compensation Programs (OWCP) is enhancing its medical bill processing system to capture the provider NPI and taxonomy number for billing and servicing providers. Providers are encouraged to include NPI and taxonomy number when billing for services provided to injured or ill workers for the Office of Workers’ Compensation Programs.
Online Bill Entry (web portal direct data entry):
Refer to the Direct Data Entry Billing Tutorial for instructions and examples.
- Web portal fields will be added for providers to include billing and rendering (servicing) NPI and taxonomy.
- Be sure to note that for all claim types, the billing NPI will be added to your bill based on your OWCP provider record. You may update the billing NPI on your bill prior to submitting.
Note: If the wrong billing NPI populates on your bill, please be sure to submit a provider enrollment update with the correct NPI information. For step-by-step instructions, refer to the quick reference guide Updating Provider Information in the Provider Portal - Messaging may appear on the portal to ensure NPI and taxonomy are both entered
Mail (paper form):
Refer to the billing instructions for each claim form by visiting the OWCP Forms and References page and selecting the OWCP Program (DCWMC, DEEOIC, or DFEC).
Health Insurance Claim Form (OWCP-1500):
- Billing provider NPI is to be entered in Box 33a and billing taxonomy is to be entered in Box 33b
Note: If you have been submitting your 9-digit billing OWCP provider ID using Box 33b, please begin entering your OWCP provider ID in Box 33 per the form instructions. - Rendering (servicing) taxonomy and rendering (servicing) NPI are to be entered in Box 24J
For Uniform Health Insurance Claim Form (OWCP-04):
- Billing provider NPI is to be entered in Box 56 and billing taxonomy is to be entered in Box 81CCa
- Attending (servicing) NPI is to be entered in Box 76 and attending taxonomy is to be entered in Box 81CCb
For ADA Dental Claim Forms:
- Billing provider NPI is to be entered in Box 49 and billing taxonomy is to be entered in Box 52a
- Treating (servicing) NPI is to be entered in Box 54 and servicing taxonomy is to be entered in Box 56a
EDI (HIPAA 837s): Refer to the updated 837 Companion Guide.
- 837 file segment details for billing provider NPI and taxonomy
NPI or Taxonomy 837 File Segment NPI Loop – 2010AA
Segment – NM1
NM108: Identification Code Qualifier = XX
NM109: NPITaxonomy Loop – 2000A Segment – PRV
PRV01: BI (Billing)
PRV02: PXC (Qualifier for taxonomy code)
PRV03: Provider taxonomy code
Example: PRV?BI?PXC?207Q00000X~ - 837 file segment details for servicing provider NPI and taxonomy PRV03: Provider taxonomy code
Claim Type Location NPI or Taxonomy 837 File Segment Professional/Dental Header NPI Loop: 2310B — RENDERING PROVIDER NAME
Segment: NM1?82
NM108: Identification Code Qualifier = XX
NM109: NPI
Example : NM1?82?1?DOE?JANE?C???XX?1234567804~Taxonomy Loop: 2310B
Segment: PRV
PRV01: PE (Performing)
PRV02: PXC (Qualifier for taxonomy code)
PRV03: Provider taxonomy code
Example: PRV?PE?PXC?1223G0001X~Line NPI Loop: 2420A — RENDERING PROVIDER NAME
Segment: NM1?82
NM108: Identification Code Qualifier = XX
NM109: NPI
Example: NM1?82?1?DOE?JANE?C????XX?1234567804~Taxonomy Loop: 2420A
Segment: PRV
PRV01: PE (Performing)
PRV02: PXC (Qualifier for taxonomy code)
PRV03: Provider taxonomy code
Example: PRV?PE?PXC?208D00000X~Institutional Header NPI Loop: 2310A - ATTENDING PROVIDER NAME
Segment: NM1?71
NM108: Identification Code Qualifier = XX
NM109: NPI
Example: NM1?71?1?JONES?JOHN????XX?1234567891~Taxonomy Loop: 2310A
Segment: PR
PRV01: AT (Attending)
PRV02: PXC (Qualifier for taxonomy code)
Example: PRVAT?PXC?208D00000X~
New messaging will appear on your remittance voucher to alert you if any of the required NPI or taxonomy information is missing or does not match your provider record. Be sure to view the Explanation of Benefits (EOB) Quick Reference Guide for further details.
For additional information, contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.
Division of Coal Mine Workers' Compensation (DCMWC):
1-800-638-7072
Division of Energy Employees Occupational Illness Compensation (DEEOIC):
1-866-272-2682
Division of Federal Employees' Compensation (DFEC):
1-844-493-1966