RFI Browser

Back  RFI # 784: 837D line item qualifiers

Formal vs. Informal Help Informal Formal

Submitter

Ranah Anani

Description

There is a inconsistency in the qualifiers used to denote repriced and adjusted repriced line item numbers in the 837D.

837P, 837I, and 837D all in agreement
2300 REF - Repriced Claim Number Qualifier 9A
2300 REF - Adjusted Repriced Claim Number Qualifier 9C


837P and 837I versus 837D
837P/I: 2400 REF - Repriced Line Item Reference Number Qualifier 9B
837P/I: 2400 REF - Adjusted Repriced Line Item Reference Number Qualifier 9D

837DI: 2400 REF - Repriced Line Item Reference Number Qualifier 9A
837DI: 2400 REF - Adjusted Repriced Line Item Reference Number Qualifier 9C

Shouldn't line item reference number qualifiers for the 837D be 9B and 9D, and not be equal to the claim-level qualifiers?

Response

This issue is explicitly addressed in guide 005010X224. The 2400 Loop Repriced and Adjusted Repriced Claim numbers do in fact use codes 9A and 9C respectively. While the 5010 837P and 837I guides use different qualifiers, there is nothing that requires that the 837D guide use the same qualifiers. Usage of the same qualifiers at the claim and service level should not pose any problem, and has been done in other guides for other types of data. Compliance with guide 005010X224 requires use of the 9A and 9C qualifiers for this information.
Submission 5/14/2009
Status Date 5/15/2009
Status F - Final
Primary References
Document 005010X224
Section2.3.2
Page304
Set ID837
Loop2400
Segment PositionREF01