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Back  RFI # 490: CLP and NM1 segments are empty

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Submitter

alan bodentein

Description

A provider level adjustment was reported in a PLB segment of the 835. The CLP and NM1 segments of the 835 do not contain any data because the 835 is an adjustment and not related to any claims. Are the CLP and NM1 segments still mandatory even though they do not contain any data? If they are removed will the 835 become non-compliant.

Submitter Assigned Keywords

CLP and NM1 segments empty

Response

This issue is explicitly addressed in guide 004010X091. "Loop Usage" on page 38 states "If the first segment is Required, the loop must occur at least once unless it is nested in a loop that is not being used."
Since the CLP and NM1 segments are part of the 2100 loop and the CLP is Required, they must be present whenever the Situational 2000 loop is present.
The 2000 loop is Situational and therefore it is valid to have an 835 without any 2000 loop or 2100 loop (i.e., CLP or NM1 segments).
It is important to note that a CLP or NM1 segment without any data is not acceptable and would violate the implementation guide as well as the ASC X12 syntax requirements of the 835. Each of those segments has required elements that must contain valid data (for example, in the case of AN type elements, valid data is at least one non-space character).
Submission 11/20/2006
Status Date 12/20/2006
Status F - Final
Primary References
Document 004010X091
Section3.1
Page164
Set ID835
Loop2100
Segment IDCLP