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Back  RFI # 729: 837P X222 2300/2400 CR1

Formal vs. Informal Help Informal Formal

Submitter

Description

It is possible for an ambulance to be dispatched but the patient not be transported from the scene. There may be charges related to this event if care is rendered on the scene. Are submitters supposed to include the segments noted as "required on all claims involving ambulance transport services" when there are ambulance charges but no tranportation was provided? Required element CR104 (ambulance transport reason code) does not include a code value to use when an ambulance is dispached but transport is not actually conducted. So if submitters are supposed to include these segments, please provide guidance as to what value should be used to populate CR104.

A formal X12 response is not required to satisfy this request.

Submitter Assigned Keywords

CR1 Ambulance transport

Response

This issue is explicitly addressed in guide 005010X222. The Situational Rule for the 2300 CR1 segment reads "Required on all claims involving ambulance transport services. If not required by this implementation guide, do not send." The 2400 loop CR1 segment rule states that it is used when info different than the 2300 CR1 elements needs to be reported. The operative here is "transport services". Since the premise for this question is that no transport services occurred, the CR1 segment can't be sent. Therefore, CR104 doesn't get populated.
Submission 2/11/2009
Status Date 3/10/2009
Status F - Final
Primary References
Document 005010X222
Section2
Page211
Set ID837
Table2
Loop2300
Segment Position1950
Segment IDCR1
Element Position04
Industry NameAmbulance Transport Reason Code
External Code List1317
Secondary References
RFI ID 654
Document 005010X222
Section2
Page368
Set ID837
Table2
Loop2400
Segment Position4250
Segment IDCR1
Element Position04
Industry NameAmbulance Transport Reason Code
External Code List1317