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Channel: CMS 1500 claim form and UB 04 form- Instruction and Guide
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Can we leave CMS BOX 32 AS blank

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Answer is Yes, read below

32 Line 1
Service Facility Name

Required if Service Facility Location is present in 32a
Enter name of service facility only if Service Location is different than Billing Provider name in box 33, otherwise leave box 32 blank. If this is included the service facility must be affiliated with the billing facility.

32 Line 2
Service Facility Address line 1
Required if Service Facility Location ID is present in 32a
Enter Street Address of Service Facility, only if Service Location address is different than Billing Provider address in box 33, otherwise leave box 32 blank.

32 Line 3
Service Facility Address line 2
Not Required
Enter additional service facility address line if needed and service location if different than billing provider address in box 33, otherwise leave box 32 blank.


32 Line 3 or 4
Service Facility City, State and Zip Code
Required if Service Facility Location is present in 32a
Enter Service Facility city, state, and zip code, only if Service Location address is different than Billing Provider address in box 33, otherwise leave box 32 blank.


32a
Service Facility Location ID (NPI)
Required, if applicable
If you bill with an NPI, enter the 14-digit service location identifier only if the services were rendered at a location other than that of the billing provider in box 33. Do not enter any other value in box 32a. For example, 1234567890-001. If this is included the service facility must be a part of your billing facility.


32b
Service Facility Location ID (blank)

Required, if applicable
If you bill with an Idaho proprietary number (not an NPI) enter the 12-digit service location identifier only if rendered at a location other than that of the billing provider in box 33. Do not enter any other value in box 32b. For example, M1234567-001 or A1234567-001. If this is included the service facility must be a part of your billing facility.

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