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Back  RFI # 1684: Use of LX in REF*6R of 835

Formal vs. Informal Help Informal Formal

Submitter

David Bennett

Description

RFI 223 indicates that there is no requirement to send the LX value as a line item control number unless the REF*6R is not sent in the 837 and splitting is involved. The 5010 835 language now seems to indicate that the LX should not be sent back in the REF*6R unless splitting or bundling occurs:

"Required when a Line Item Control Number was received on the original claim or when claim or service line splitting has occurred. If not required by this implementation guide, do not send."

In 4010, some systems were always returning the LX number in the REF*6R when no original line control number was sent in the 837. With this "do not send" language now in the 5010, was it the intent to consider transactions that always return the LX value when no line control number was included in the 837 to be out of compliance?

Submitter Assigned Keywords

REF 6R LX line control number

Response

In 5010, the REF*6R is required to be returned in the 835 only when sent in on the 837 or in situations of claim or service splitting. It is not allowed to be sent if not received on the 837 or in situations where claims or services were not split. Using the LX number in the REF*6R is not compliant, except in situations of claim or service splitting.
Submission 9/14/2012
Status Date 11/2/2012
Status F - Final
Primary References
Document 005010X221
Section2.4
Set ID835
Table2
Loop2110
Segment Position1000
Segment IDREF
Element Position01
Industry NameLine Item Control Number