Section title: Requests for Interpretation
RFI #
1536
5010 2310A usage clarification
Description

The 837I TR3 states that NM102 entity type qualifier now only can have a value of '1- Person'. However, NM103 still has an element name of "Name Last or Organization Name". Some payers are using that as an argument to allow them to require a facility name to be reported in this loop. This is confusing and seems to be out of compliance since a facility isn't a person. Is it allowable to have any other entity reported in this loop other than a person?

RFI Response

The 2310A attending provider is a person not a facility. Service facilities are reported in loop 2310E.

In the 2310A NM103 the phrase “Name Last or Organizational Name” refers to NM103 segments in general. The TR3 defines this specific NM103 to be the “Attending Provider Last Name”.The 2310A attending provider is a person not a facility. Service facilities are reported in loop 2310E.

In the 2310A NM103 the phrase “Name Last or Organizational Name” refers to NM103 segments in general. The TR3 defines this specific NM103 to be the “Attending Provider Last Name”.The 2310A attending provider is a person not a facility. Service facilities are reported in loop 2310E.

In the 2310A NM103 the phrase “Name Last or Organizational Name” refers to NM103 segments in general. The TR3 defines this specific NM103 to be the “Attending Provider Last Name”.

DOCUMENT ID
005010X223A2