Section title: Requests for Interpretation
RFI #
1192
837P - LQ02 - Form ID Code
Description

There is conflicting information in the 837P guide related to LQ02. The UT qualifier indicates the value in LQ02 is from the CODE SOURCE 582: Centers for Medicare and Medicaid Services (CMS) Durable Medical Equipment Regional Carrier (DMERC) Certificate of Medical Necessity (CMN) Forms. The sample form included with Example 8 in the TR3 guide is clearly identified as form 02.03B - this is also included in the X12 example data. This form number does not appear on the 2010 DME MAC CMNs and Other Forms Used by DME MAC Jurisdiction A listing. This form number also fails compliance when testing with one of the certificiton vendors.

Please advise if this is an error in the guide, the CMN list or the certificaion vendor.
Thanks in advance for your assistance.

RFI Response

The examples in the 837 Implementation Guides are just that, examples. The data included in these examples were based on information available at the time the Guides were published. X12 has no control over external code sets including CMN forms. The examples in the Implementation Guides provide guidance on segment and element structure. The examples should not be relied upon to reflect the accuracy of data in elements representing externally controlled code sets.

DOCUMENT ID
005010X222