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Back  RFI # 1007: Service Location on 837P

Formal vs. Informal Help Informal Formal

Submitter

Wendy Eames

Description

In instances where one pay-to provider has multiple service locations attached to it, is it possible to populate the NM101 segment in the 2310D loop with 77 qualifier, populate the REF01 segment in the 2310D loop with LU qualifier and enter the service location ID in the REF02 segment? We cannot reimburse providers properly without knowing the service location ID. NHIC has tested claims with both LU and 1D qualifiers and has denied them.

Submitter Assigned Keywords

Service Location ID NM101 77

Response

Guide 004010X098A1 doesn’t exclude the usage of secondary proprietary IDs to identify the Service Facility when they are necessary for that identification, and supports up to five secondary identifiers. However, the intent of the ASC X12 837 workgroup was to allow only one occurrence of each allowable qualifier within the REF segment. Prior to NPI mandate each payer's identifier was accommodated by using the 2310D Loop for the destination payer and the 2330G Loop for the non-destination payers. When NM109 in Loop 2010AA contains the NPI and the Health Care Provider chose not to enumerate its subpart being sent in 2310D, then reporting primary and secondary identifiers in the Service Location in Loop 2310D is prohibited by CMS FAQ.
Submission 3/26/2010
Status Date 5/28/2010
Status F - Final
Primary References
Document 004010x098
Section3
Page289
Set IDNM1
Loop2310D
Segment PositionNM101