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Back  RFI # 1048: 837P - require 2330B REF*F8

Formal vs. Informal Help Informal Formal

Submitter

Gloria Davis

Description

Please clarify if Payers can require the the 2330B REF*F8 with the Medicare ICN on COB claims when Medicare is primary payer and the claim is coming directly from a Provider (not Payer to Payer).

Per the Payer requirement:
If Medicare is a primary payer, this segment must be sent with the ICN number that Medicare assigned to this claim.
2330B REF01 = F8
2330B REF02 = Medicare ICN number.


In the COMBINED 004010X098 & 004010X098A1 - Page 350

• 837 • 2330B • REF - Page 350 it states:

Used when it is necessary to identify the ’other’ payer’s claim number
in a payer-to-payer COB situation (use code F8). Code F8 is not used
by providers.

By reading the above information I would expect that the payer could not require a provider to have to send the 2330B REF*F* with the Medicare ICN.

Submitter Assigned Keywords

2330B REF

Response

This issue is explicitly addressed in guide 004010X098. Note # 2 on the 2330B loop REF segment states "Used when it is necessary to identify the ’other’ payer’s claim number in a payer-to-payer COB situation (use code F8). Code F8 is not used by providers."

Therefore, a payer can not require that a provider send the Medicare claim number and a provider is not able to send that information.
Submission 5/18/2010
Status Date 6/9/2010
Status F - Final
Primary References
Document 004010X098
Section837
Page368
Set IDREF
Loop2330B