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Back  RFI # 2050: 2330B N404 Country Code Usage

Formal vs. Informal Help Informal Formal

Submitter

Betty Westbrook

Description

Clarification is needed for the usage of 2330B N404. N404 states "Required when address is outside the United States." which is a true statement as it is Canada. The 2330B states "Required when the payer address is available and the submitter intends for the claim to be printed on paper at the next EDI location (for example, a clearinghouse). If not required by this implementation guide, do not send." Is this statement intended to be based on only if the receiver is printing the claim(this case a payer), or to be considered if the provider would print the claim at a next location.

Response

The segment situational rule is processed first. If the situational rule is met, then the data element situational rules are processed. If the situational rule of the segment is not met, then in this case the “If not required by this implementation guide, do not send.” applies. The data element situational rules would not be processed.

The situational rule is based on whether the submitter intends the claim be printed at the next EDI location, not whether the receiver actually prints the claim out. If the N4 is present, then the submitter intends the claim be printed and if the address is outside of the United States, then N404 would be required.
Submission 5/12/2015
Status Date 8/27/2015
Status F - Final
Primary References
Document 005010X223
Section2.4