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Back  RFI # 265: 837- 2300&2400 loops the same

Formal vs. Informal Help Informal Formal

Submitter

Paul Wanderscheid

Description

Our organization that does our 837 HIPAA validation says the 'Ambulance Certification' in Loop 2400 must be different than the 'Ambulance Certification' in Loop 2300 and rejects claims if both loops are the same. To back this up they respond that the Notes for Loop 2300- Ambulance Transport Information say "The CR1 segment in Loop 2300 applies to the entire claim unless the exception is reported in the CR1 segment in Loop 2400"and in addition, Claredi testing produces a HIPAA error for this as well.

However CMS says that for Medicare crossover claims we receive via COBC that although the guide notes that 2400 is required if it is different than reported at 2300 it does not state that you can't submit 2400 if it is the same.

Who is correct? And I think this situation applies to a number of loops in which although we would prefer duplicative loops like this not be submitted the IG doesn't explicitly say you can't. Thanks.

Response

While the intent of the Implementation Guide is not to send duplicate data in the 2400 loop, it still may be submitted at the sender's discretion.
Submission 6/10/2005
Status Date 9/1/2005
Status F - Final
Primary References
Document 0004010X098
Section3.1
Page257
Set ID837P