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Back  RFI # 1786: 2320 OI06 Note 837P

Formal vs. Informal Help Informal Formal

Submitter

Mendenhall Gigi

Description

The 2320 OI06 note states "This is a crosswalk from CLM09 when doing COB." Is the intent of this note to mean the 2300 CLM09 and 2320 OI06 should match, or does this mean in a COB situation the inbound 2300 CLM09 should be moved to that payers 2320 OI06 when sending to another payer?

For example: Medicare receives a Primary Claim where the 2300 CLM09 is I and there is a 2320-2330 for a Supplemental Trading Partner 12345. Within the 2320-2330 the OI06 is equal to Y. When sending the claim on to the Supplement Payer 12345, is it correct that the 2320 OI06 for that payer be moved to the 2300 CLM09? Also, should the 2300 CLM09 received by Medicare be moved to the Medicare itteration of the 2320 OI06 being sent to the Supplement payer 12345?

Submitter Assigned Keywords

OI06 CLM09

Response

The CLM09 is a claim level attribute obtained by the provider. This value does not change from payer to payer. Therefore, in version 5010, it would not make sense for the CLM09 and the OI06 not to be the same value. If these elements are different, one of the values is incorrect. The crosswalk depicted in Section 1.4.1.2 of the TR3 explains where to obtain data values when building a secondary claim, but in this case the values would be the same and a crosswalk is not needed. To address this confusion the OI06 element is no longer used in version 6020.
Submission 5/7/2013
Status Date 6/19/2013
Status F - Final
Primary References
Document 005010X222
SectionTable 2
Page309
Set ID837P
Table2
Loop2320
Segment IDOI
Element Position06
Industry NameRelease of Information Code