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Back  RFI # 1536: 5010 2310A usage clarification

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Submitter

peg cavender

Description

The 837I TR3 states that NM102 entity type qualifier now only can have a value of '1- Person'. However, NM103 still has an element name of "Name Last or Organization Name". Some payers are using that as an argument to allow them to require a facility name to be reported in this loop. This is confusing and seems to be out of compliance since a facility isn't a person. Is it allowable to have any other entity reported in this loop other than a person?

Submitter Assigned Keywords

5010 2310A NM103

Response

The 2310A attending provider is a person not a facility. Service facilities are reported in loop 2310E.

In the 2310A NM103 the phrase “Name Last or Organizational Name” refers to NM103 segments in general. The TR3 defines this specific NM103 to be the “Attending Provider Last Name”.
Submission 3/5/2012
Status Date 4/27/2012
Status F - Final
Primary References
Document 005010X223
Section2.4
Page319
Loop2310A
Segment PositionNM1
Element Position3