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Back  RFI # 1377: 5010 837P Loop 2310C

Formal vs. Informal Help Informal Formal

Submitter

stephen lang

Description

Re: Place of Service and Loop 2310C Location

The Hipaa 5010 837P document requires the 2310C loop containing Service Facility Location Name, Service Facility Location Address and Service Facility Location City, State, ZIP Code.

For testing laboratories, the place of service can be 81 (lab itself), 31 or 32 (nursing or skilled nursing facility), or 12 (patient home).

It is plain what information to put into loop 2310C in the case of POS 81, 31 or 32. If the POS is 12, does this loop now require the patient's name and address, complete with 9 digit zip code, even though the patient's name and address with 5 digit zip have been supplied in Loop 2010.

Thank you for any help you can give.

Submitter Assigned Keywords

loop 2310C 5010 837P service facility location place of service

Response

This issue is explicitly addressed in the 5010 837 Professional implementation guide. The related 2310 Service Facility Location Name loop NM1 segment situation rule states for both guides "Required when the location of health care service is different than that carried in Loop ID-2010AA (Billing Provider). If not required by this implementation guide, do not send."

Therefore, if services are rendered in the patient's home and the patient's home address is not the same as the billing provider address then the Service Facility Location Name loop is required and must be completed by providers.

The NM108 and NM109 of this segment are only required if the entity being reported has an NPI and is not a component or subpart of the Billing Provider.
Submission 8/8/2011
Status Date 10/24/2011
Status F - Final
Primary References
Document 005010X222
Section1.1
Set ID837P
Loop2310C
Industry NameService Facility Location Name