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Back  RFI # 283: 837P X098A1 Purchased Services

Formal vs. Informal Help Informal Formal

Submitter

Brian Kitts

Description

837P, 4010A1, We would like some clarification regarding when segments for purchased services are required. We have some differing opinions.
If only the AMT01=NE is present, are the PS1 and NM101=QB required ?
If only the NM101=QB is present, are the PS1 and AMT01=NE required ?
If only the PS1 is present, are the NM101=QB and AMT01=NE required ?
Thanks in advance.

Submitter Assigned Keywords

837P X098A1 purchased services PS1 NM101=QB AMT01=NE

Response

The presence of purchased services make the claim level Purchased Service AMT segment and Purchase Service Provider loop required.

The service line level PS1 is required when service line purchased service charge amounts are needed by the payer for processing. It would not be logical to have a PS1 segment without also having the claim level amount and provider segments.
Submission 7/14/2005
Status Date 9/16/2005
Status F - Final
Primary References
Document 004010X098A1
Section387P
Page206
Set ID837P
TableD
Loop2300
Segment Position175
Segment IDAMT
Element Position01
Industry NameAmount Qualifier Code
Code ValueNE