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Back  RFI # 1584: REF- Prior Authorization 837I

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Submitter

Caldwell Laura

Description

837I, Loop 2300 REF- Prior Authorization

The second TR3 note for this Segment says that the PA in the 2300 applies to the entire claim unless overwritten by a PA in the 2400. However, in the 837I there is no place to put a PA in the 2400.

Is this an oversight during publishing, since the 2400 Loop in the 837I does not contain a Prior Approval Reference segment?

Submitter Assigned Keywords

Prior Authorization REF PA 2300

Response

The second TR3 note was applied to the segment in order to align the requirements across claim types. Since the 837I does not allow for the creation of a PA in the 2400 the rule will never apply and should be ignored.

This has been addressed in the next version of the 837I TR3.
Submission 5/2/2012
Status Date 8/1/2012
Status F - Final
Primary References
Document 005010X223
Section2
Page164
Table2
Loop2300
Segment Position1800
Segment IDREF
Industry NamePrior Authorization