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Back  RFI # 1038: 40 & 5010 835's for one tax ID

Formal vs. Informal Help Informal Formal


Jan Klimper


If a provider submits both 4010A1 and 5010A1 837 claims, is it required that a 4010A1 835 be created for the 4010A1 claims, and a 5010A1 835 be created for the 5010A1 claims? Or, can one version of the 835 be sent for all claims?

Submitter Assigned Keywords

835 4010 5010 version


This issue is explicitly addressed in guide 005010X221. Section 1.4 states "The 835 is intended to meet the particular needs of the health care industry for the
payment of claims and transfer of remittance information." Section 1.7 states "One 835 transaction set can account for claims submitted using multiple 837 transactions." Specifically, this statement does not identify a version of the 837.

Therefore, the 835 is independent of the format of the original claim. Paper, 4010 837 and 5010 837 claims can all be reported within the same 4010 or 5010 835.
Submission 5/4/2010
Status Date 5/5/2010
Status F - Final
Primary References
Document 005010X221