Section title: Requests for Interpretation
RFI #
1111
837P
Description

Where is Oxygen Therapy Certification submitted in the 5010 837 Professional Claim? The 4010A1 837P supported two types of certification in the 2400 CRC DMERC Condition segment; that is, DME Certification (CRC01 = 09) and Oxygen Therapy Certification (CRC01 = 11). However, the 5010 version of the 837P only supports DME Certification and no longer contains the code value in CRC01 for Oxygen Therapy Certification. Where is Oxygen Therapy Certification submitted in the 5010 837 Professional Claim? The 4010A1 837P supported two types of certification in the 2400 CRC DMERC Condition segment; that is, DME Certification (CRC01 = 09) and Oxygen Therapy Certification (CRC01 = 11). However, the 5010 version of the 837P only supports DME Certification and no longer contains the code value in CRC01 for Oxygen Therapy Certification.

RFI Response

In 4010, home oxygen therapy certification information was supported in several segments, in addition to Loop 2440 – Form Identification Code. The information in these segments is part of the Centers for Medicare & Medicaid Services (CMS) Durable Medical Equipment (DME) form number 484.03. To ensure that there is only one way to submit this information, the segments listed below were removed from the professional 5010 TR3. Loop 2440 should be used to report the information previously contained in these version 4010 Segments of the 837 professional.

CR5 – Home Oxygen Therapy Information

CRC – DMERC Condition Indicator

DTP – Oxygen Saturation/Arterial Blood Gas Test Date

MEA – Test Result

REF – Oxygen Flow Rate

DOCUMENT ID
005010X222