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Back  RFI # 2066: 5010X223A1 - DUP 2330B

Formal vs. Informal Help Informal Formal

Submitter

Vo Huong

Description

837I Duplicate Loop 2330B.
Per TR3, loop 2320 can be up to 10 times, each of it must have one loop 2330B. We have a situation when submitter sent loop 2320 like this:
SBR*A*18*******HM~OI***Y***I~
NM1*PR*2*XXXXX HEALTH PLAN*****PI*JJJJJJJ162~
SBR*P*18*******MA~OI***Y***Y~
NM1*PR*2*MEDICARE*****PI*01011~
SBR*S*21*******MC~OI***Y***Y~
NM1*PR*2*YYYYYY MEDICAID*****PI*70055~
SBR*T*21*******MC~
OI***Y***Y~
NM1*PR*2*YYYYYY MEDICAID*****PI*70055~ (Note: the last two NM1*PR are duplicate).
Per 2300 CLM loop, is this valid to have duplicate 2330B NM1*PR even though they are in a separate 2320 loop? We looked in TR3, there is no information to indicate that sending a duplicate NM1 segment in the 2330B loop is invalid.

Submitter Assigned Keywords

#16859

Response

If the secondary and tertiary payer IDs are identical, this would create a conflict for the translator with the 2430 SVD segment in the 5010 version of the 837I. The SVD01 would have the same value for both payers. As recommended in RFI 1933, a prefix or suffix could be added to the payer ID to differentiate the two. A change was made in the next version to allow for this scenario.
Submission 6/25/2015
Status Date 8/6/2015
Status F - Final
Primary References
Document 005010X223A2
Section2.3.1
Page295
Set ID837 I
Table2
Loop2330B
Segment Position2900
Segment IDNM1
Industry NameOther Payer Name