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Back  RFI # 1994: Consult regarding 2310C loop u

Formal vs. Informal Help Informal Formal

Submitter

Michael Jimenez

Description

We are receiving rejects from a Clearinghouse on Independent Laboratories (CLM05.1=’81’) claims when Service Facility Location and Billing Provider Location are the same. Clearinghouse is requesting to include the 2310C loop (Service Facility) even though when such location is the same location than the one reported on 2010AA loop (Billing Provider).

It is our understanding of the IG that loop 2310C can not be included if the Service Facility location is the same as the one reported in 2010AA (Billing Provider) loop. Clearinghouse interpretation is that they can require loop 2310C in these cases.

We are seeking a clarification from X-12 on this, so that either Clearinghouse or us might make appropriate changes in order to comply with the rules.

Thank you,

Michael Jimenez

Submitter Assigned Keywords

Facility, 2310C

Response

This issue is explicitly addressed in Implementation Guide 005010X222A1. The Situational usage rule of the 2310C NM1 – Service Facility Location Name reads “Required when the location of health care service is different than that carried in Loop ID-2010AA (Billing Provider). If not required by this implementation guide, do not send”. Therefore, when the Service Facility Location is the same as that reported as the 2010AA Billing Provider, it must not be sent.
Submission 11/24/2014
Status Date 1/12/2015
Status F - Final
Primary References
Document 005010X222A1
Section2
Page271
Set ID837P
Table2
Loop2310C