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Back  RFI # 910: Use of patient account number

Formal vs. Informal Help Informal Formal

Submitter

James McConnell

Description

The 276 addenda has added a note that states that the TRN02 corresponds to th CLM01. Does this mean that if the provider has sent a patient account number for the claim, that TRN02 must be that patient account number?

Submitter Assigned Keywords

276 TRN02

Response

This issue is addressed explicitly in guide 004010X093A1. The note on TRN02 reads "This data element corresponds to the CLM01 data element of the ASC X12N Dental, Institutional, and Professional Implementation Guide(s)." The 837P guide also states for CLM01 "The two recommended identifiers are either the Patient Account Number or the Claim Number in the billing submitter’s patient management system"; as a result, the contents of CLM01 may be either a patient account number or a provider claim number.
Therefore, if the original claim was an 837, the contents of CLM01 must be conveyed as TRN02 in the 276 - but that number might not be a patient account number. It must be whatever the provider sent for that claim. If the provider sent a patient account number in the 837 then that number must be used in the 276 as well.

Recommendation

Due to various issues identified with the 004010X093A1 use of CLM01 data content in the TRN02, the data content of the 005010X212 TRN02 was changed to be a true transactional tracking number for re-association of the 276 Request and corresponding 277 Response(s). The data content of the CLM01 value from the 837 claim will now be passed in the Loop 2200D/E Patient Control Number REF of the 005010X212.
Submission 11/24/2009
Status Date 1/21/2010
Status F - Final
Primary References
Document 004010X093A1
Section3
Page11
Set ID276
Segment IDTRN
Element Position02