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Back  RFI # 682: Loop 2420A REF*SY

Formal vs. Informal Help Informal Formal

Submitter

Jennifer Delmont

Description

Our Compliance checker is failing 837P transactions when loop 2420A REF01=SY with an error that it is invalid for Medicare. We as the destination payer are not Medicare (loop 2000B SBR09=ZZ) therefore I believe this is an invalid error. The other primary payer in Loop 2320 is Medicare but loop 2420A is not part of loop 2320 therefore I do not believe this should be considered.

Is this error valid?

Response

The 2420A Line Level Rendering Provider Secondary Identification REF is used to identify the Rendering Provider when the primary ID NM109 is insufficient When NM109 contains the NPI, the provider is identified and reporting of additional identifiers is prohibited by CMS FAQ 5816.
Submission 9/2/2008
Status Date 2/4/2010
Status F - Final
Primary References
Document 004010X098A1
Section2420A
Page507
Set ID0