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Back  RFI # 1537: 5010 2310E usage clarification

Formal vs. Informal Help Informal Formal

Submitter

peg cavender

Description

In the 837I TR3, Loop 2310E NM102 only has an entity type qualifier of "2 - non-person entity". However, element NM103 has a name of "Name Last or Organization Name". In the instance of a hospice or home health claim when clearly all services will be rendered at a location different than that of the location carried in Loop 2010AA (a home health or hospice agency will not provide services at the office), some payers are requiring the name and address of the patient in this loop. Is this allowable? This seems to be out of compliance with the qualifier. If the services were provided in a nursing home facility not associated with the billing provider, should that facility name be required to be reported in this loop?

Submitter Assigned Keywords

5010 2310E NM103

Response

The SERVICE FACILITY LOCATION NAME is “required when the location of health care service is different than that carried in Loop ID-2010AA (Billing Provider).” Therefore, if the service was provided in the patient’s home that information must be reported in the 2310E Loop and adhere to all the segment and element usage rules and notes.

Recommendation

When sending this loop to report the patient's home, it is recommended that you use "Residence" or a description of the location of the service to fulfill the requirement for NM103.
Submission 3/5/2012
Status Date 6/5/2012
Status F - Final
Primary References
Document 005010X223
Section2.4
Page341
Loop2310E
Segment IDNM1
Element Position2