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Back  RFI # 161: 837P 2310A Entity Code

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Submitter

Sara Welsch

Description

We have a payer who is requiring that we use "P3" as the Entity Identifier Code in the first iteration of Loop 2310A of the 837P. We are sending a single iteration of this loop. They are rejecting our claims if we do not submit using this Identifier. The Implementation Guide specifically states that the "P3" is to be used only in the second iteration of Loop 2310A.
Are there instances where this usage is appropriate?
Is the requirement of our payer permissable?

Response

The X098 guide clearly does not allow the use of code P3 when the loop is only used once. This issue is explicitly addressed in the value notes for codes DN and P3 in the loop 2310A NM101 and 2420F NM101.
Submission 12/2/2004
Status Date 2/16/2005
Status F - Final
Primary References
Document 004010X098A1
Section3
Page282
Set ID837P
Table2
Loop2310A
Segment Position250
Segment IDNM1
Element Position01
Industry NameReferring Provider Name/Entity ID Code
Code ValueDN,P3