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Back  RFI # 308: Tooth Number -835

Formal vs. Informal Help Informal Formal

Submitter

Sarah Hataway

Description

We have a request to return the tooth number on the 835 transaction, but I have not been able to locate a satisfactory place to return this information. Is there a place on the 835 that this information can be returned?

Response

The structure of the 835 does not allow for the tooth number to be returned. If the provider has a need to receive the specific tooth/surface denial detail, then the provider can submit the services as separate lines, each with their own control number.

The Line Item Control number assigned by the provider on the incoming claim must be returned in the 835 in table 2, position 100 REF segment, using a qualifier of 6R. This unique identification number will allow the provider to auto post the service into their Account Receivable system and identify any adjustments made to the service/tooth/surface.

A DSMO (522) was submitted on 11/29/01 that requested the addition of the TOO segment to the 835. The request was denied. For additional information regarding this DSMO, please go to http://www.hipaa-dsmo.org/Search.asp.
Submission 8/12/2005
Status Date 11/11/2005
Status F - Final
Primary References
Document 004010X097A1
Section3
Page139
Set ID835
Table3
Loop2110
Segment Position352
Segment IDSVC
Element Position1
Component Position7
Industry NameDescription