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Billing L&I and/or CVC using your NPI
For electronic billing to L&I
Use the table below to determine if you need to test with L&I before you use your NPI to bill electronically.
| Biller type | Criteria | Test? |
| Providers submitting bills | 1. Directly to L&I - In the HIPAA compliant 837 format | Y |
| 2. Using a clearinghouse | N | |
| Clearinghouses | Y | |
| Provider or clearinghouses submitting bills | Using the proprietary HCFA format. (You can only use the L&I provider number with this format.) | N/A |
If you need to test before you bill
How you can test
Review L&I's Transaction Testing Procedures (48 KB PDF) for EDI transaction requirements and expectations for using providers' NPI. Download the Companion Guide for EDI transactions (605 KB PDF/3 min.).
To schedule testing, contact Electronic Billing Unit at 360-902-6511 or ebulni@Lni.wa.gov.
When you may begin testing
Providers and clearinghouses may begin testing with the Electronic Billing Unit when you are ready to transition your EDI transactions to using NPI. After successful testing, you may submit your EDI transactions with the NPI only.
Identifiers and taxonomy codes for billing L&I and/or CVC
| Taxonomy Code | ||||
| Form or Transaction | Provider ID options | Tax ID required? | Required? | Used for adjudication? |
| Paper bills (L&I and CVC) | ||||
| CMS 1500 | Legacy only, NPI/Legacy, NPI only | Y | Not required, but preferred | Can be used if submitted to L&I during NPI registration. |
| UB04 | Legacy only, NPI/Legacy, NPI only | Not required, but preferred | Not required, but preferred | Can be used if submitted to L&I during NPI registration. |
| 837I Electronic bills (L&I only) | ||||
| Billing provider - 2010AA | Legacy only, NPI/Legacy, NPI only | Y | N/A | N/A |
| Pay to provider - 2010AB (Include only if this is a different entity than the billing provider. If included, will be used as the payee and override the billing provider). | Legacy only, NPI/Legacy, NPI only | N | N/A | N/A |
| Attending physician - 2310A | Legacy only, NPI/Legacy, NPI only | N | Not required, but preferred | N/A |
| Operating physician - 2310B | Legacy only, NPI/Legacy, NPI only | N | Not required, but preferred | N/A |
| Other provider - 2310C | Legacy only, NPI/Legacy, NPI only | N | Not required, but preferred | N/A |
| Service facility - 2310E | Legacy only, NPI/Legacy, NPI only | N - Required when location of health care service is different than the billing - 2010AA or pay to provider - 2010AB loops. | Not required, but preferred | N/A |
| 837P Electronic claims (L&I only) | ||||
| Billing provider - 2010AA | Legacy only, NPI/Legacy, NPI only | Y | N/A | N/A |
| Pay to provider - 2010AB (Include only if this is a different entity than the billing provider. If included, will be used as the payee and override the billing provider) | Legacy only, NPI/Legacy, NPI only | Y | N/A | N/A |
| Referring provider - 2310A | Legacy only, NPI/Legacy, NPI only | N | Not required, but preferred | N/A |
| Rendering provider - 2310B | Legacy only, NPI/Legacy, NPI only | N | Not required, but preferred | N/A |
| Service facility - 2310C | Legacy only, NPI/Legacy, NPI only | N - Required when location of health care service is different than the billing - 2010AA or pay to provider - 2010AB loops. | N/A | N/A |
| 270/271 Eligibility/benefits (L&I only) | ||||
| Subscriber provider | N/A | N/A | N/A | N/A |
| Dependent provider | N/A | N/A | N/A | N/A |
| 276/277 Claim status (L&I only) | ||||
| Service provider | N/A | N/A | N/A | N/A |
| U277 Claim status (L&I only) | ||||
| Service provider | N/A | N/A | N/A | N/A |
