Invalid CCLF5 data

[Lightbeam Development]

Hello,

We have a client (ACO D.0086) that is wondering why sometimes the CLM_RNDRG_PRVDR_TAX_NUM and RNDRG_PRVDR_NPI_NUM values in CCLF5 are incorrect.  For example, occasionally we get the values below.

CLM_RNDRG_PRVDR_TAX_NUM = 999999999
RNDRG_PRVDR_NPI_NUM = 9999999992

CLM_RNDRG_PRVDR_TAX_NUM = 111111111
RNDRG_PRVDR_NPI_NUM = 9999999992

Is this expected behavior?

Thanks,
LB

[Beneficiary Claims Data API (BCDA) Community]

Hi LB, 

Thank you for your question.

Yes, this is expected behavior for both CCLF and BCDA data. These values are placeholders that get inserted when the real rendering provider TIN or NPI is not available at the time the claim is created.  The values you shared for CLM_RNDRG_PRVDR_TAX_NUM and RNDRG_PRVDR_NPI_NUM reflect that the actual provider values were not included.

Thanks,
The BCDA Team