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Back  RFI # 1635: LookupAttempted-MID

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Submitter

Jamie Dixon

Description

Would it be compliant/correct to return an AAA01 = Y when a match was not found on the ID (AAA03=72) but the data in the element met the payer's requirements for format, datatype, length and existence? We believe an AAA01 = N would not be appropriate when no match is found because we believe AAA01 = N must only be returned when the value sent in NM109 required correcting by the provider per the payer's format, data type, length and/or existence requirements.

Submitter Assigned Keywords

MID Search

Response

Yes it would be compliant/correct to return the AAA01 = Y when a match was not found on the ID (AAA03=72) but the data in the element met the payer's requirements for format, datatype, length and existence. It would not be compliant to return an AAA01=N when the data exists, and meets the payer's specifications. An AAA01=N should only be returned when the payer's specifications have not been met (invalid) or the data does not exist but is expected (missing).
Submission 7/24/2012
Status Date 9/18/2012
Status F - Final
Primary References
Document 005010X279
Section3
Page262
Set ID271
Table2
Loop2100C
Segment Position0850
Segment IDAAA
Element Position01
Code ValueN