Section title: Requests for Interpretation
RFI #
2453
270 2100B NM101=1P and NM102=2 Allowed?
Description

In the 5010 270 2100B NM1, when NM101 (Entity Identifier Code) = 1P, is the NM102 (Entity Type Qualifier) always required to be "1" (Person)?  Is it non-compliant if NM101=1P and NM102=2 (Non-Person)?

RFI Response

Response:
The 5010 Health Care Eligibility Benefit Inquiry and Response (270/271) guide does not define any of the codes available in data element 2100B NM101 specifically to be either a person or non-person.  Data element 2100B NM102 also does not have any situational rules or restrictions with the usage of codes 1 or 2 with any code in the NM101.  Therefore, the referenced inquiry complies with guide requirements.

DOCUMENT ID
005010X279A1