RFI Browser

Back  RFI # 1817: 277 Service Date

Formal vs. Informal Help Informal Formal

Submitter

Julia Dunicheva

Description

We'd like to clarify how 2200D DTP Service Date should be used. Situational rule states: "Required for institutional claims or for professional and dental claims when the service line date is not used. "
How this note should be interpreted:
1) Required
(for institutional claims)
or
(for professional and dental claims when the service line date is not used).
2) Required (for institutional claims or for professional/dental claims) when the service line date is not used.

I.e. for institutional claims: is it required all the times or only when loop 2220D is not used?

Response

Your first interpretation is correct.

There are multiple conditions that can apply from the first sentence of the Situational Rule, which make the rule as follows:

The 2200D DTP - Claim Service Date is required when the 2200D Loop is used and any of the following conditions is true:
•the claim is an institutional claim
•the claim is a professional claim and the service line date is not used
•the claim is a dental claim and the service line date is not used

If none of these conditions is true, the Claim Service Date may be provided at the sender's discretion but cannot be required by the receiver.
Submission 6/26/2013
Status Date 8/5/2013
Status F - Final
Primary References
Document 005010X212
Section2.4
Set ID277
Loop2200D
Segment IDDTP
Industry NameClaim Service Date