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Back  RFI # 959: 278 Response Inconsistencies

Formal vs. Informal Help Informal Formal


Heidi Monroe


The 278 Request allows for 1P, 2B, 36, and FA in NM101 of Loop 2010B.

However, the Response only allows for 1P and FA. If a 2B or 36 are sent in the Request, should these be filtered in the Response? What if only a 2B or 36 were sent in the Request? The NM segment is required in the Response. What should be sent in the Response if we only got a 2B or 36 in the Request?

Similarly, in Loop 2010B, in NM108, an XV can be sent in the Request but not in the Response. What should be sent back in the Response if XV is sent in the Request?


The response to your first question in relation to the NM101 values in Loop 2010B has previously been answered in HIR 733.

In response to your second question in relation to NM108 and code value XV in Loop 2010B, at this time the Centers for Medicare and Medicaid Services Plan ID (code value XV) has not been proposed or a final rule published. Therefore, this code would not be used. In the event the Plan ID is finalized while version 5010 is still in use, an errata will be developed to correct this situation. In addition, this will be corrected in the next version of the guide.
Submission 2/8/2010
Status Date 3/12/2010
Status F - Final
Primary References
Document 005010X217
Set ID??
Segment PositionNM1