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Back  RFI # 262: DMG segment in 277 2000D Loop

Formal vs. Informal Help Informal Formal

Submitter

Whicker Jim

Description

The May 2000 IG indicates on loop 2000 D(subscriber) that the DMG segment is required. In the “standard” section, there is a “set note” that indicates “The DMG segment may only appear at the Subscriber (HL03=22) or Dependent(HL03=23)level.”

The summary Page(121) shows:

LOOP ID - 2000D SUBSCRIBER LEVEL >1
146 010 HL Subscriber Level R 1
148 040 DMG Subscriber Demographic Information R 1

This indicates that the DMG segment is required at the 2000D loop.

Then – in the addenda – October 2002 page 8 – the element shows as situational (below) – but there is no update indicating that the usage changed.

LOOP ID - 2000D SUBSCRIBER LEVEL >1
70 010 HL Subscriber Level R 1
72 040 DMG Subscriber Demographic Information S 1

We’re assuming that the intent is the DMG is only sent at the subscriber level in the 277 when the patient is the subscriber. If the patient is NOT the subscriber, the DMG is not sent in the 200D loop.

Submitter Assigned Keywords

277 DMG 2000D Required or Situational

Response

This issue is explicitly addressed in guide 004010X093A1 on pages 45 and 70. The loop 2000D,table 2, Position 040 DMG segment is Situational. The situational usage for the segment is "Required when the subscriber is the patient. Not used when the subscriber is not the patient."
Submission 6/3/2005
Status Date 6/15/2005
Status F - Final
Primary References
Document 004010X093
Section277
Page122
Set ID277
Table2
Loop2000D
Segment Position040
Segment IDDMG
Industry NameSubscriber Demographic Information