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Back  RFI # 347: X12 837 4010 K3 segments

Formal vs. Informal Help Informal Formal


Annette Gabel


NCPDP has been working on a mapping document from the X12 837 4010 to the NCPDP 5.1 guide. We were unable to find fields in the X12 837 to obtain information necessary to process an NCPDP 5.1 Claim Billing transaction.
Therefore we are requesting the use of the K3 segment in both the 2300 and 2400 loop. We are using the 2400 loop for individual ingredients related to a compound claim.
We have been working with a task group comprised of both NCPDP and X12 members in an effort to complete this mapping so it can be developed and used for the Medicare Part D Program that becomes effective on 1/1/06.
I can provide the documents with the requested use of the 2300 and 2400 loops and the NCPDP field references and definitions under seperate cover. If you have any questions, I can be reached at 201-269-3510.


The workgroup agrees with the request. More background and support of the request is as follows: Two co-chairs and some members of WG2 have worked in concert with NCPDP since summer to map the X12 837 4010A1 to the NCPDP 5.1 guide, for Medicare Part D. Most of the data needs were mapped successfully. They have determined that there are no other data elements in the X12 837 4010A1 to house the remainder of the data, and with the Medicare Part D effective date of 1-1-06, have concluded there is no other alternative than to use the K3 in both the 2300 and 2400 loops for these remaining data elements if situationally required by the NCPDP data dictionary for use in Medicare Part D.
Submission 10/25/2005
Status Date 12/20/2005
Status F - Final
Primary References
Document 004010X098A1
Section837 2300
Set ID837
Segment IDK3
Element Position01