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Back  RFI # 260: 2010AA vs 2310B information

Formal vs. Informal Help Informal Formal

Submitter

Bill Williamson

Description

In sending 837P claims to a major clearinghouse, we are encountering a problem with a single payer. As a matter of course, we send the tax id for the medical practice in Loop 2010AA, NM109 with the ‘24’ qualifier in NM108. In Loop 2310B, we send the Rendering Physician’s social security number in NM109 with the 34 qualifier in NM108. We also include in this loop an REF segment with an ‘EI’ qualifier in REF01 and repeat the practice tax id in REF02.



The specific payer in question, rejects the claims because they want the practice tax id in NM109 of Loop 2310B. (Yes, they use the practice tax id for every individual doctor in the practice)



Is their requirement consistent with the intent of the ANSI standard? .

Submitter Assigned Keywords

loop 2310B tax id

Response

This issue is explcitly addressed in guide 004010X098. Note 3 for the 2310B Rendering Provider Name states "Required when the Rendering Provider NM1 information is different than that carried in either the Billing Provider NM1 or the Pay-to Provider NM1 in the 2010AA/AB loops respectively." In addition, the ID provided in NM109 is directly related to the entity identified in the rest of the NM1 segment. Its business name is Rendering Provider Identifier. A Payer requirement to repeat a value already provided in 2010AA or 2010BB and that is not specific to the rendering provider is not consistent with these instructions.
Submission 6/2/2005
Status Date 8/15/2005
Status F - Final
Primary References
Document 004010X098A1
SectionASC X12N
Page290
Set IDNM1
Loop2310B
Segment IDNM1
Element Position09