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Back  RFI # 2151: CPT04 Units for the 837I and 8

Formal vs. Informal Help Informal Formal

Submitter

Joyce Petrucci

Description

The NUCC clearly states the following for reporting quantity for the 837 professional:
Additional Information for Reporting NDC
When entering supplemental information for NDC, add in the following order: qualifier, NDC code, one
space, unit/basis of measurement qualifier, quantity. The number of digits for the quantity is limited to
eight digits before the decimal and three digits after the decimal. If entering a whole number, do not
use a decimal. Do not use commas.
Examples: 1234.56
2
99999999.999

Question: Does this also apply to the 837I? The NUBC is silent and so is the TR3.

Submitter Assigned Keywords

CPT04 Drug Quanity

Response

The convention for reporting the NDC on paper claim forms does not apply to electronic claims. In the 837 claim transactions, the information is reported in discrete data elements and it is not necessary for the TR3 to describe a convention for sending multiple elements in one position.

The NDC code Qualifier is sent in data element LIN02 using a value of "N4", the NDC code is sent in data element LIN03, the drug quantity is sent in data element CTP04, and the unit or basis of measurement code is sent in data element CTP05-01; all of which are in Loop ID 2410 in both the 837 Professional and 837 Institutional claim transactions.

Recommendation

For information related to the formatting of the value populated in the CTP04 National Drug Unit Count, please see RFI #1924.
Submission 5/31/2016
Status Date 7/14/2016
Status F - Final
Primary References
Document 005010X223
Section1.11.1
Page44
Loop2410
Segment IDCTP
Element Position04