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Back  RFI # 748: 5010 2330B

Formal vs. Informal Help Informal Formal

Submitter

David Macaleer

Description

The 5010 TR3 X223 shows the loop 2330B N3 segment for Other Payer Address as Situational but it shows the N4 segment for Other Payer City, State, Zip code as Required. Is this correct? The City, State and Zip Code are required but the address is not?

This is also shown in 5010 TR3 X222.

Response

This issue is explicitly addressed in guide 005010X223. The 2330B Loop N3 segment is Situational with a situational rule that reads "Required when the payer address is available and the submitter intends for the claim to be printed on paper at the next EDI location (for example, a clearinghouse). If not required by this implementation guide, do not send." Therefore, the address N3 segment can't be used when the conditions are not met and must be used when they are met. The N4 segment in the 2330B loop is Required, and must be present when the 2320 and 2330B Loops are present.
Submission 3/24/2009
Status Date 6/10/2009
Status F - Final
Primary References
Document 005010X223
Section2.4
Page386
Set ID837
Table2
Loop2330B
Industry NameOther Payer Address