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Back  RFI # 256: 2330A/C REF=SY when Medicare

Formal vs. Informal Help Informal Formal

Submitter

Ginger Wright

Description

The 2330A Other Payer Subscriber Id Number REF01 Grey Box Note states "The SSN may not be used for Medicare." The 2330C Other Payer Patient Id Number REF01 Grey Box Note states "Do not use this code for Medicare." Does the use of the term 'may not' make it allowable to submit an SSN in the 2330A REF? Or should an SSN not be allowed in the 2330A REF as is the case in the 2330C REF when the other payer is Medicare?

Submitter Assigned Keywords

2330A Medicare SSN

Response

This issue is explicitly addressed in guide 004010X096. The notes on the 2330A and 2330C REF segment, element 1, code SY both state a requirement that the Social Security Number NOT be used when the information is related to Medicare as a payer. Use of the term "may not" is conveying the same level of restriction, just in a different voice. Since these loops are part of the Other Subscriber Information loop, the exclusion relates to situations where the corresponding 2330B loop identifies Medicare as the payer. The Social Security Number information may be sent when Medicare is not the payer in the corresponding 2330B loop and the other related conditions apply.
Submission 5/10/2005
Status Date 5/13/2005
Status F - Final
Primary References
Document 004010X096A1
Section3
Page403
Set ID837
Table2
Loop2330A
Secondary References
RFI ID 217
Document 004010X068A1
Section3
Page340
Set ID837
Table2
Loop2330C