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Back  RFI # 498: Line Ctrl # on Unbundled Line

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Submitter

Bob Resh

Description

Is there any requirement for a payer to report a line item control number submitted on the original claim in the REF 6R segment for all related returned lines in the remittance when unbundling occurs for that line?

Response

While the usage of the line item control number is not explicitly included in the instructions for unbundling, that does not eliminate the requirement to return the line item control number on the 835 when it was submitted on the original claim.
To assist the provider in reconciling their patient account, the original claim information must be retained. This includes not only the Claim Submitter’s Identifier but also the original submitted line item control number in the REF segment, loop 2110. If the original claim did not contain a specific line item control number for the service line, the line item sequence number (LX01) can be used.
In the case of unbundling a service line the line item control number must be reported back on all returned service lines that where unbundled from that original claim service line.
Submission 12/5/2006
Status Date 1/26/2007
Status F - Final
Primary References
Document 004010X091A1
Section2.2.6
Page27
Set ID835
Secondary References
RFI ID 449
Document 004010X091A1
Section3
Page154
Set ID835
Table2
Loop2110
Segment Position100
Segment IDref
Industry NameLine Item Control Number
Code Value6R