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Back  RFI # 1968: 837 PWK02 FT usage

Formal vs. Informal Help Informal Formal

Submitter

matthew klischer

Description

The 837 PWK segments (Claim Supplemental Info and Line Supplemental Info) are required when there is a paper (no specific PWK02 identified in the situational rule), electronic (situational rule specifies that PWK02 is EL) or at the provider’s discretion, if the info is held at the provider’s office and available at payer request (PWK02 is AA).
The segment cannot be sent in other situations (if not required, do not send).
PWK02 = FT (indicates the attachment is warehoused) is listed as a valid option but the situational rule does not appear to allow its use as it is not an appropriate transmission code for a paper attachment and FT is not listed as permissible with electronically transmitted attachments.
Can FT be submitted in a compliant manner?

Submitter Assigned Keywords

837 PWK PWK02 FT

Response

'FT' is a permitted value in the version 005010 837 claims TR3's PWK02 data elements. ASC X12 acknowledges that the 2300 PWK - Claim Supplemental Information segments Situational Rules do not specifically address the usage of the FT qualifier in the PWK02 element. However, use of the FT qualifier falls within the usage requirements of when it is necessary to send the attachment electronically, separately. Therefore, use of the FT qualifier is compliant with the 5010 837 TR3’s.

Recommendation

Please submit a change request through http://changerequest.x12.org/ process so that the usage requirements of this segment can be modified to more clearly address this use in a future TR3.
Submission 9/18/2014
Status Date 11/7/2014
Status F - Final
Primary References
Document 005010X223
Section2.4
Page154
Loop2300