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Back  RFI # 677: 2410 LIN Segment Repeat

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Submitter

JoEllen Fouts

Description

Claims are rejecting when multiple 2410 loop (LIN) segments are being repeated within one 2400 (SV2) loop. Listed below is an example of a claim submitted with multiple LINs within one SV2.

Multiple LINs within one SV2 (loop 2400)
SV2 *0250**21.5*UN*2~
DTP*472*D8*20080621~
LIN**N4*63323066401~
CTP***4*10*GR~
REF*XZ*5232439~
LIN**N4*00009019009~
CTP***17.50*10*GR~
REF*XZ*5232439~

The MedaTran is rejecting the claim with the following message
IG EDIT 0000 ISA 00 99 630 RECORD CANNOT FOLLOW 630 RECORD

System is allowing only one 2410 loop. Clarification by X12 was requested by FISS in order for this issue to be corrected

Response

Implementation Guide 004010X096A1 allows up to 25 repeats of the 2410 loop. Therefore, there are two valid ways to code multiple 2410 loops that are associated with the same HCPCS J-code. The multiple loops can be coded within one 2400 Service Line loop. Or, each 2410 loop can be coded in a separate 2400 Service Line loop. Both coding methods are supported by the guide and therefore are acceptable ways to code this situation.

Recommendation

The 005010 version of this Implementation Guide eliminates the multiple ways to code this situation by allowing a single NDC (Loop ID 2410) be linked to a single HCPC (Loop ID 2400). If there are multiple ingredients (NDCs) that link to a given HCPC, the HCPC is reported as a separate line (Loop ID 2400) for each associated ingredient. The workgroup recommends that trading partners voluntarily adopt that coding scheme for the current version.
Submission 8/5/2008
Status Date 2/2/2009
Status F - Final
Primary References
Document 004010X096A1
SectionTable 2
Page449
Set ID2410