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Back  RFI # 1959: 271 2110C/D DTP01 = 290

Formal vs. Informal Help Informal Formal

Submitter

Dennis Zanetti

Description

Our product processes payer 271 messages, and we have seen multiple interpretations of this value, so we are requesting clarification regarding the intent of qualifier 290 'Coordination of Benefits'.

Is this intended to be the date on which the patient's COB information was updated or verified? Or is there another interpretation.

Response

The meaning of code 290 must be evaluated based upon the contents of DTP02, which identifies the date format.

When the 2110C/D DTP02 contains code D8 (date as CCYYMMDD), DTP01 code 290 (Coordination of Benefits) is intended to indicate that the related date is the start date for COB with the payer identified in the related 2120C/D loop.

When the 2110C/D DTP02 contains code RD8 (date range as CCYYMMDD-CCYYMMDD), DTP01 code 290 (Coordination of Benefits) is intended to indicate the effective start and end dates for COB with the payer identified in the related 2120C/D loop.

Recommendation

To provide the verification or last update date, use the 2110C/D DTP segment element 01 code "636", meaning "Date of Last Update".
Submission 8/12/2014
Status Date 9/22/2014
Status F - Final
Primary References
Document 005010X279
Section2.4
Page317
Loop2110C
Code Value290