RFI Browser

Back  RFI # 700: Compound Drug Reporting in 837

Formal vs. Informal Help Informal Formal

Submitter

John Murray

Description

In the TR3s for both the 837P 5010X222 and the 837I 5010X223 it states in section 1.11.2, Compound Drug Billing, that "An 837 for a multiple ingredient compound will have one 2400 loop for each ingredient ..."
In both TR3s, however, the Drug Identification (2410) Loop does not repeat. (It did so in the 4010/4010A1, but this has been changed in the 5010) How are we to report additional ingredients for compound drugs i nly one instance of the 2410 loop is allowed per service line (2400) loop??

Submitter Assigned Keywords

NDC compound drug 2410

Response

Guide 005010X222 explicitly states in section 1.11.2 "An 837 for a multiple ingredient compound will have one 2400 loop for each ingredient with the HCPCS code in SV101-2,". Therefore, a single 2400 loop reporting a compound drug (all components) rather than a single component is non-compliant. Since a single 2400 loop can only report a single component, there is no possible need for more than one iteration of the 2410 loop. One 2410 loop provides the NDC code for the single drug in the 2400 loop. Multiple 2400 loops are necessary to report a compound drug, each with a 2410 loop (if necessary). The separate components of the compound drug are tied together by the 2410 loop REF segment.
Submission 10/30/2008
Status Date 2/2/2009
Status F - Final
Primary References
Document 005010X222
Section1.11.2
Page44
Set ID837
Table2
Loop2410