Section title: Requests for Interpretation
RFI #
2425
SVD Line Adjudication (837)
Description

005010X223 837 - SVD Line Adjudication Information (Pg 479)
SVD05 - Quantity - Paid Service Unit Count

How should the Paid Service Units be reported if the service items grouped for primary but itemized for secondary? Or should the service item grouping be the same from both primary and secondary?

Response

Each payer is identified in a separate loop 2430 in the 837I therefore SVD05 for each payer should reflect how that payer returned it to the provider on the remittance advice. Regarding bundling and unbundling of services, guidance is provided in the TR3 notes: 

To show unbundled lines: If, in the original claim, line 3 is unbundled into (for example) 2 additional lines, then the SVD for line 3 is used 3 times: one for the original adjustment to line 3 and then two more times for the additional unbundled lines.

DOCUMENT ID
005010X223