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Back  RFI # 852: Pharm Prescription No 276/277

Formal vs. Informal Help Informal Formal

Submitter

Marcia Henderson

Description

The 277 allows for the return of the pharmacy prescription number at 2200D and 2200E depending on whether the response is for the subscriber or a dependent. The REF segment for the Pharmacy Prescription number if situational. The situation rule indicates the pharmacy prescription number must be returned when it is submitted on the 276 or when available on claims located in the Information Source's system.

The REF has a repeat of 1. How should the 277 be returned when an information source has a single claim in their system with multiple service lines each containing a unique pharmacy prescription number?

Response

This issue is not currently addressed in the guide. The workgroup recognizes there is a discrepancy between the 276/277 transaction and the 837 transaction as to where Pharmacy Prescription Number is reported (claims vs. service level). At this time, Service Line Item Identification REF segment is the only line level tracking number that can be returned in the 277. The Pharmacy Prescription Number reporting discrepancy will be addressed in a future version of the 276/277 guide.
Submission 9/9/2009
Status Date 10/23/2009
Status F - Final
Primary References
Document 005010X212
Section2.4
Page152
Set IDREF