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Back  RFI # 413: 837-PER Segment-Telephone Ext

Formal vs. Informal Help Informal Formal

Submitter

Carol Lewis

Description

Our organization handles the HIPAA validation for clients that receives Medicare crossover claims via COBC. Within these claims the PER segment contains the telephone extension only, the telephone number is not present.

We set an error if the telephone number does not precede the extension.

COBC says the telephone number is not necessary and that we should not reject their claims when only the telephone extension is present.

The edit is based on the PER segment note that states: “The extension, when applicable, should be included in the communication number immediately after the telephone number.”

We reviewed the 5010 draft Implementation Guides and the note is changed to read: “The extension, when applicable, must be included in the communication number immediately after the telephone number.”

Is this the correct intention of X12 that a reject should occur if the telephone number does not precede the telephone extension regardless of who sends or receives the claim?

Submitter Assigned Keywords

PER, PER Segment, Telephone Extension, Telephone Ext

Response

While it is the intent of the implementation guide that telephone numbers as well as extension numbers reported in a PER segment be a valid numbers, the question of rejection is not addressed directly in the guide. X12 transactions can be accepted with errors if the errors will not prevent processing of the business transaction. Any question of rejection for HIPAA compliance should be addressed to askhipaa@cms.hhs.gov.

Recommendation

It is the workgroup's opinion that rejection for this reason would not be conducive to a good business relationship.

X12N DISCLAIMER: X12N's interpretations are intended only to clarify the implementation guides. It is not within X12N's scope to comment on the actions of specific entities such as regulatory bodies, carriers, and providers, nor to render an opinion on an individual entity's compliance with HIPAA or other federal or state regulations. Requests concerning interpretations of the HIPAA regulations as issued by the Department of Health and Human Services should be submitted via email to askhipaa@cms.hhs.gov.
Submission 5/30/2006
Status Date 7/24/2006
Status F - Final
Primary References
Document 004010X096A1
SectionN/A
Page64
Set ID837