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Back  RFI # 1567: Loop 2400 SV111 005010X222A1

Formal vs. Informal Help Informal Formal

Submitter

mary jo denton

Description

The situational rule for loop 2400 sv111 states "Required when Medicaid services are the result of a screening referral. If not required by the guide, do not send."

Then it goes on to say the following: For this implementation, the listed value takes precedence over the semantic note. When this element is used, this service is not the screening service.

Should SV111 be used when submitting a screening service that resulted in a referral, or when the service being submitted is not the screening service but was the result of the referral after a screening service?

Submitter Assigned Keywords

SV111

Response

As stated, the SV111 situational rule reads "Required when Medicaid services are the result of a screening referral. If not required by the guide, do not send." The TR3 supporting note states "When this element is used, this service is not the screening service."

Therefore, the service being reported in this SV1 segment when SV111 is present is not the screening service. It is the service that was performed as a result of the screening service, from which a referral was created that resulted from the screening service conclusions.
Submission 4/17/2012
Status Date 5/24/2012
Status F - Final
Primary References
Document 005010X222
SectionLoop2400
Loop2400
Segment Positionsv1
Segment ID107
Element Position11