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Back  RFI # 1439: 5010 837i DOS for OP

Formal vs. Informal Help Informal Formal

Submitter

Artis D'Ann

Description

According to the 5010 837i TR3 Guide, the Date - Service Date (2400/DTP*472) segment is "Required on outpatient service lines where a drug is not being billed and the Statement Covers Period is greater than one day. OR Required on service lines where a drug is being billed and the payer's adjudication is known to be impacted by the drug duration or the date the prescription was written. If not required by this implementation guide, do not send."

This seems to indicate that the 2400/DTP*472 segment must not be reported on inpatient claims unless a drug is billed on the claim. Is this interpretation correct?

Submitter Assigned Keywords

DOS, Service Date

Response

Your interpretation is correct about the guide instructions for a provider/submitter creating an 837. Unless an inpatient claim meets the requirement of "a drug is being billed and the payer's adjudication is known to be impacted by the drug duration or the date the prescription was written", the Service Date segment (2400/DTP*472 ) falls into the "do not send" category. The designation of inpatient / outpatient and exceptions are as stated in the NUBC manual.
Submission 10/21/2011
Status Date 1/19/2012
Status F - Final
Primary References
Document 005010X223
Section2.4
Set ID837i
Table2
Loop2400
Segment Position4550
Segment IDDTP