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Back  RFI # 369: 837P 2420E Required for DMERC

Formal vs. Informal Help Informal Formal

Submitter

Don Collier

Description

As a followup to HIR 343, if the 2400 PWK (DMERC CMN) is present, the IG states that the 2420E N3 and N4 are required. The IG does not say that the 2420E NM1 is required in this situation, only when the Ordering Provider is different from the Rendering Provider, which is unknowable by the receiver. Would the N3 and N4, and therefore the NM1 also, be required when the 2400 PWK is present, even if the Ordering Provider and Rendering Provider are the same entity?

Submitter Assigned Keywords

DMERC CMN 2420E

Response

All DMERC claims require a 2420E Ordering Provider NM1 segment. The note indicates to use it when the Ordering is different than the Rendering. This is true of all DMERC claims since the ordering is the one who ordered the equipment or oxygen and the rendering is the Supplier that supplied the equipment or oxygen.
Some of the DMERC claims also have a CMN, DIF or Oxygen Therapy Certification form. When this occurs, the suppler also gives the Ordering Provider’s address info (that is listed on the CMN) in the 2420E N3 and N4 segments and completes the 2400 PWK - DMERC CMN INDICATOR.
Submission 12/16/2005
Status Date 2/14/2006
Status F - Final
Primary References
Document 004010X098A1
SectionN/A
Page529
Set ID837
Table4
Loop2420E
Segment Position500
Segment IDNM1
Industry NameOrdering Provider Name