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Back  RFI # 1975: 837I, PCP group, Inpatient

Formal vs. Informal Help Informal Formal

Submitter

Jacqueline Harris

Description

Is there any way in the 837I claim to report a Referring Provider that is not a person but is a group on an inpatient claim?

Submitter Assigned Keywords

837I Group 5010 PCP INPATIENT

Response

Submitting a group as a referring provider is not supported by the 5010 837I.

The claim level referring provider entity type qualifier located at 2310F NM102 only allows for value of “1” which indicates person. The 2420D line level referring provider includes the same restriction. In order to submit a group a value of “2” non-person would need to be a allowed value.

Recommendation

If you wish this functionality included in a future version of the guide a change request will need to be filed including the business case. More informaiton on change request can be found at http://changerequest.x12.org/
Submission 9/25/2014
Status Date 2/18/2015
Status F - Final
Primary References
Document 005010X223
Section1.1