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Back  RFI # 212: 277 Loop 2200E REF 1K

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Submitter

Pam Cottrell

Description

Please clarify the use of REF with 1K qualifier when the claim cannot be found. When a payer is responding to a 276 request for a claim status on a dependent and the payer cannot find a claim matching the criteria what do we use for a default value in the 277 Loop 2200E REF (1K-Payer Claim Identification Number) segment?

Response

The 004010X093A1 Implementation Guide does not define a default value for the required 277 Loop 2200E REF – Payer Claim Identification Number. When a claim match is not found, it is at the Information Source’s discretion to determine what default value to return.

Recommendation

Although not limited to the following list, some potential default values for Information Sources to use are: zero(s), the words ‘NONE’ or ‘NOT APPLICABLE’ or the 276 Loop 2200E Payer Claim Identification Number, if one was submitted.

The 277 Loop 2200E REF – Payer Claim Identification Number has been made Situational in subsequent versions of the transaction.
Submission 3/4/2005
Status Date 4/12/2005
Status F - Final
Primary References
Document X04010X093A1
Sectiondetail
Page210
Set ID277
Table2
Loop2200E
Segment Position110
Segment IDREF
Element Position02