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Back  RFI # 1799: Patient Cntrl Nbr for Voids

Formal vs. Informal Help Informal Formal

Submitter

Peggy Billhartz

Description

5010 837s - If an 837 claim is submitted as a Void (CLM05-3 = 8), should that claim in the production system contain the Patient Control Number (CLM01) of the original claim being voided or the new Void CLM01 value?

Or, should the CLM01 value of the Void claim be equal to the original claim being voided CLM01?

The TR3s notes on CLM01 recommend a unique identifier.

Submitter Assigned Keywords

837 CLM01

Response

The CLM01 is used by the submitter as a key in the submitter's system to match the claim to the payment. The two recommended identifiers are either the Patient Account Number or the Claim Number in the billing submitter's patient management system. There is no requirement that the CLM01 values of the original and voided claims either be the same or different. This is dependent upon how the values are managed in the submitter's system. It is up to the submitter to determine how best to use this value to maintain control of the claims in their system.

Recommendation

The note on CLM01 also states "The developers of this implementation guide strongly recommend that submitters use unique numbers for this field for each individual claim". For the business stated, there is only one claim - the original that is now being voided. It is recommend that the CLM01 of a void claim equal the CLM01 of the original.
Submission 5/22/2013
Status Date 6/21/2013
Status F - Final
Primary References
Document All 837s
SectionTable 2
Loop2300
Segment IDCLM
Element Position01
Industry NamePatient Control Number