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Back  RFI # 1863: 837i REF-PAYER CLAIM CONTROL #

Formal vs. Informal Help Informal Formal

Submitter

matthew klischer

Description

Current:
Situational Rule: Required when CLM05-03 (Claim Frequency Code) indicates this claim is a replacement or void to a previously adjudicated claim. If not required by this implementation guide, do not send.

CMS has a business need to identify the payer claim control number on re-billed claims and cannot based on the current situational rule.
CMS requests an interpretation that removes the replacement/void restriction so that usage can be allowed on re-billed claims. CMS believes the restriction was unintended.
CMS suggests the interpretation be similar to the following:
Required when the payer claim control number is applicable to this claim. If not required by this implementation guide, do not send.

Response

The ASC X12 Request for Interpretation (RFI) Portal provides access to information related to the meaning, use, and interpretation of ASC X12 Standards, Guidelines, and Technical Reports, including Technical Report Type 3 (TR3) implementation guidelines. The information is available in the form of responses to questions submitted by implementers of the ASC X12 products.

The RFI portal is not a mechanism for requesting modifications to the ASC X12 Standards, Guidelines, or Technical Reports.

Please submit the above request to modify an ASC X12 Technical Report Type 3 (TR3) through the online TR3 Maintenance Request tool at:

http://www.x12.org/TR3ChangeRequest/
Submission 9/25/2013
Status Date 11/15/2013
Status F - Final
Primary References
Document 837i
SectionREF
Loop2300