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Back  RFI # 1970: 837I 2400 DTP Service Date

Formal vs. Informal Help Informal Formal

Submitter

Elizabeth Cramer

Description

Need clarification on use of the ‘RD8’ Qualifier in DTP02 of 837I Loop 2400 Service Date segment.
The TR3 states: "RD8 is required only when the “To and From” dates are different. However, at the discretion of the submitter, RD8 can also be used when the “To and From” dates are the same."
Please clarify the phrase “To and From dates are different”. What ‘To’ and ‘From’ dates?
We can understand when the same service/procedure is rendered on two or more days – RD8 in DTP02 could be used to list the 1st and last service date.
But let’s take an ED visit that happens to span midnight, thus the Statement Dates (2300 DTP*434) are different. The hospital only posts ONE ED E/M charge to the account and industry standard is that the line item date of service for the ED E/M service is the date ED care started. Can the usage of RD8 in the 2400 DTP Service Date be required for the ED E/M Service Line if the patient was in the ED over midnight? Is this appropriate use of the RD8 qualifier?

Submitter Assigned Keywords

RD8 DTP*472

Response

We understand your example as follows- an institutional outpatient bill covers a period of 2 days, so the Statement From and To Date (2300/DTP*434*RD8) reports two different dates. The patient was admitted to the Emergency Department on day one and was released on day two. One service is billed. You ask what is appropriate to report for the Service Date (2400/DTP*472).

For your example, the Service Date (2400/DTP*472) is required by the situational rule because the Statement Dates indicate a period greater than one day. Although not stated explicitly, the service date is required because the service date cannot be determined from the Statement Dates when the Statement Dates indicate a period greater than one day.

The TR3 allows a single service date (DTP*472*D8) or a span of service dates (DTM*472*RD8). As stated in the DTP02 note, RD8 is required only when the ‘To and From’ dates are different. The DTP02 note also allows RD8, at the discretion of the submitter, when the ‘To and From’ dates are the same. The context of the DTP02 note is intended to mean the ‘To and From’ dates that are reported in DTP03 when DTP02 is RD8.

Service Date TR3 note 1 describes a drug scenario that requires a date range. No other date range scenarios are described in the TR3. Therefore, the industry convention of reporting a single service date for each outpatient service is appropriate. Thus, DTP*472*D8 is most appropriate for your example, although DTP*472*RD8 (with identical dates) is allowed at the discretion of the submitter. The TR3 does not allow RD8 to be required by the receiver.
Submission 9/19/2014
Status Date 3/13/2015
Status F - Final
Primary References
Document 005010X223
Section2.4
Page433
Table2
Loop2400
Segment Position4550
Segment IDDTP
Element Position02
Industry NameService Date