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Back  RFI # 1697: XV Qualifier and HPID/OEID

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Submitter

Christopher Gracon

Description

For data element 66, code value 'XV' has a description of 'Centers for Medicare and Medicaid Services PlanID'. With the recently issued regulations establishing HPID and OEID, could both of these IDs be able to be used with the 'XV' qualifier, or would only the HPID be able to be used?

Asked another way, if there is a TPA who is processing claims for self-insured group health plans, who would not qualify for HPID, but could get OEID, would the OEID be sent with the 'XV' qualifier, or would that need to be sent with one of the other allowed qualifiers in the transaction (such as 'PI' in 2010BB in 837I/P)?

Submitter Assigned Keywords

HPID OEID XV

Response

ASC X12N is in the process of evaluating the requirements of the Federal Rule as well as it's impact to the electronic transactions. Once the evaluation is complete, we will determine if changes are necessary to accommodate those requirements.

At this time, there is no expectation that the XV qualifier, in data element 66, would be applicable to both the HPID and the OEID. Only the HPID would be applicable for use with that qualifier. How the OEID could or would be referenced has not yet been determined.

This RFI will be updated once a determination has been made related to the implementation of the OEID.
Submission 10/16/2012
Status Date 11/2/2012
Status F - Final
Primary References
Document 005010X222
Section2.4
Page134
Set ID837P
Table2
Loop2010BB
Segment Position0150
Segment IDNM1
Element Position08
Code ValueXV
Secondary References
RFI ID 2156
Document 005010X221
Section2.3.1
Page88
Set ID835
Table1
Loop1000A
Segment Position0800
Segment IDN1
Element Position03
Code ValueXV