Section title: Requests for Interpretation
RFI #
2496
270 has NPI (2100B NM109) and 2100B REF
Description

Does the 005010X279 implementation guide for the 270/271 standard not permit a 270 request transaction to contain a 2100B REF Information Receiver Additional Identification segment when an NPI is reported in 2100B NM109 (2100B NM108='XX')?

RFI Response

The situational rule for the Information Receiver Additional Identification explicitly states “Required when the information in 2100B NM1 is not sufficient to identify the information receiver.  If not required by this implementation guide, may be provided at the sender's discretion, but cannot be required by the receiver.”  Regardless of if the NM108/109 contains an NPI or TIN, the REF01/02 may contain any ID the information sender feels would be beneficial to the information receiver.  The usage of the REF segment situational rule, before, during, or after the NPI Adoption Date, is the same.

DOCUMENT ID
005010X279