RFI Browser

Back  RFI # 1878: AMT - Per Day Limit

Formal vs. Informal Help Informal Formal

Submitter

Karen Shutt

Description

Please clarify the usage of the 835 2100 Loop AMT, where AMT01=DY Per Day Limit. Is the ‘per day limit’ applicable to only a Per Diem reimbursement methodology or is it applicable for any type of reimbursement methodology that establishes a specific Per Day Limit? For example, when the payment methodology is on a Per Diem basis, we assume the daily rate would be reported in the AMT? If the payment methodology is a DRG and outlier days are paid, would the dollar amount limit for the outlier days also be reported in the AMT?

Submitter Assigned Keywords

835 AMT DY-Per Day Limit

Response

The 005010X221A1 Technical Report Type 3 (TR3) does not explicitly address this question. Since the TR3 does not restrict the DY qualifier to a particular payment methodology, it is compliant with the TR3 to report the dollar amount limit for outlier days.
Submission 11/11/2013
Status Date 2/21/2014
Status F - Final
Primary References
Document 005010X221A1
SectionSection
Page183
Set ID835
Table2
Loop2100
Segment Position0620
Segment IDAMT
Element Position01
Code ValueDY