Qualifiers Needed for Referring, Ordering, and Supervising Providers

On the newly revised CMS 1500 (rev 02-12) form which will become mandetory by Medicare on April 1, 2014, providers will have to use the appropriate qualifier to indicate referring, ordering and supervising physicians. On the old CMS 1500 (08-05) form it wasn’t necessary to differentiat between referring, ordering and supvising physicians. The provider’s name and NPI were simply entered in box 17. With the new form Medicare is requiring that the appropriate qualifier is used to differentiate between referring, ordering, and supervising physicians by using the following qualifiers:

 

◦DN -> to indicate a Referring Provider
◦DK -> to indicate an Ordering Provider
◦DQ -> to indicate a Supervising Provider

 

These qualifiers should be entered to the left of the dotted vertical line in box 17. If the qualifier is not present the services will be denied.

 

Other changes on the newly revised CMS 1500 (rev 02-12):
◦Indicators to differentiate between ICD9 and ICD10 codes
◦Number of possible diagnosis codes from 4 to 12