Section title: Requests for Interpretation
RFI #
1070
837I SVD03/SVD04
Description

The SVD03 is required in 5010 whereas in 4010, the SDV03 is situational. A procedure code is not required to be sent in the SV202 in the 4010 or 5010 versions of the 837I. When the 835 returned contains an SVC segment the SVC01 is required, however, NU is a valid qualifier for both the 4010 and 5010 versions of the 835. NU is not a valid qualifier in the SVD03 in the 5010 837I. The information in the SVD of the 837 reflects the information provided on the 835. If the 837 did not contain a procedure code in the SV202 and therefore, the 835 did not contain a procedure code in the SVC01 and instead contained a revenue code how can the 837I 5010 file be populated with a procedure code in the SVD03? In addition, the SVD04 is required in 4010 and is now a not used field in the 5010 version of the 837I. How is a provider expected to identify the adjudicated revenue code in the SVD instead of a procedure code when there is no procedure code to report?

RFI Response

This issue was corrected under the ASC X12N emergency change process and has been published with the 005010X223A2 errata.

DOCUMENT ID
005010X223