Section title: Requests for Interpretation
RFI #
1410
271: 2100C/NM103 Req'd Unless
Description

In the 5010 271 response, could you please clarify this rule for 2100C/NM103: “Required unless a rejection response is generated and this element was not valued in the request. If not required by this implementation guide, do not send.” If an AAA is returned in a different loop in the 271 such as in dependent loop 2100D, does that satisfy the above condition “a rejection response is generated”? Or, must the rejection be in subscriber loop 2100C? Bottom line: If 2100C/NM103 is not present and 2100D/AAA is present and 2100C/NM103 was not valued in the 270, is the 271 compliant or not?

RFI Response

If the transaction contains an AAA segment anywhere in the transaction, that is considered a rejection response. If the 2100C NM103 was not valued on the 270 and there is an AAA segment in any loop of the 271 related to the patient request, it is compliant to return the 271 with no value in the 2100C NM103.

DOCUMENT ID
005010X279