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Back  RFI # 778: Addresses in the 837I v5010

Formal vs. Informal Help Informal Formal

Submitter

Mike Denison

Description

(Institutional 837 v5010)
Addresses in the Health Care Claim: Institutional (837) ASC X12N/005010X223 TR3 document have been updated to make the City, State, Zip Code N4 Segment required when the loop is used whether or not the Address N3 segment is present.

This impacts the Subscriber, Payer, Other Subscriber and Other Payer loops.

What should an organization do if the information for the N4 segment is not available to them?

Submitter Assigned Keywords

Address

Response

For a paired N3/N4 in the 5010 837 TR3, default to the Billing Provider N4 information if these four conditions are all met:

- the N3 is Situational,
- the situation is not met,
- the N4 is Required; and,
- the submitter does not have the city, state, and zip available.

Recommendation

Submission 5/7/2009
Status Date 8/11/2009
Status F - Final
Primary References
Document 005010X223
SectionTable 2
Page116
Set IDN4