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Back  RFI # 1286: 5010 837P line level provider

Formal vs. Informal Help Informal Formal

Submitter

Martin Wilbanks

Description

On 5010 837P if only one line item on a claim was supervised and the rest were not, is it acceptable to enter the supervising provider on the 2420D line level and leave the 2310D claim level supervisng provider as null.

Submitter Assigned Keywords

line level provider

Response

No. The intent of the situational rules for supervising provider as well as others within the claim is that the provider information needs be submitted at the claim level unless the provider for any given service line is different than that reported at the claim level.

Recommendation

If there is a mixture of services submitted on the claim where some require supervision and some do not, the recommendation is to split the claim between those services that do require supervision and those that do not, if it is known to impact the payer’s adjudication.
Submission 3/30/2011
Status Date 11/7/2011
Status F - Final
Primary References
Document 005010X222
Section2.4
Page449
Loop2420D