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Back  RFI # 501: 837i 2310E

Formal vs. Informal Help Informal Formal

Submitter

matthew klischer

Description

A provider operates with outpatient clinics physical located miles from the main campus. A patient is seen at 9:00 a.m. at an outpatient general medical clinic and then on the same day travels to a completely different location for a 1:00pm outpatient orthopedic clinic visit.
Both services are non repetitive so they must be combined on the same claim to avoid one claim being denied for outpatient claim overlap rules. The 837-I guide only allows for a single 2310E segment. What address should be used? Can the address of the main campus be used because both outside clinics operate under the main facility?

Response

The only way to report a 2nd address is to split the claim. The health plan receiving the claim would need to recognize that the services were performed elsewhere by reading the 2310E loop.
Submission 12/14/2006
Status Date 2/15/2007
Status F - Final
Primary References
Document 004010X096A1
Section2310E
Page349
Set IDNM1