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Back  RFI # 899: 837I 5010 2310A Attending Prov

Formal vs. Informal Help Informal Formal

Submitter

leslie orr

Description

Situational Rule: Required when the claim contains any service other then non-scheduled transportation claims.

How is a "non-scheduled" transportaion claim denoted within the institutional 837? Our review of condition codes, revenue codes, procedure codes do not offer any clear answers.

Response

For 5010 the Attending Provider is required in the 2310 Loop for all claims except for non-scheduled transportation claims because there is no Attending Provider associated with ambulance services. There will be an Attending Provider associated with all other claims.

Recommendation

The best indicator for transportation related services would be the ambulance revenue code (054x). The submitter would be responsible for identifying whether it was scheduled or non-scheduled, but there is no attribute within the 5010 837 claim that identifies this information. An ambulance report may need to be manually referenced.
Submission 10/27/2009
Status Date 12/18/2009
Status F - Final
Primary References
Document 005010X223
Section?
Page319
Set ID?
Loop2310A