Section title: Requests for Interpretation
RFI #
1684
Use of LX in REF6R of 835
Description

A previously submitted RFI indicates that there is no requirement to send the LX value as a line item control number unless the REF*6R is not sent in the 837 and splitting is involved. The 5010 835 language now seems to indicate that the LX should not be sent back in the REF*6R unless splitting or bundling occurs: "Required when a Line Item Control Number was received on the original claim or when claim or service line splitting has occurred. If not required by this implementation guide, do not send." In 4010, some systems were always returning the LX number in the REF*6R when no original line control number was sent in the 837. With this "do not send" language now in the 5010, was it the intent to consider transactions that always return the LX value when no line control number was included in the 837 to be out of compliance?

RFI Response

In 5010, the REF*6R is required to be returned in the 835 only when sent in on the 837 or in situations of claim or service splitting. It is not allowed to be sent if not received on the 837 or in situations where claims or services were not split. Using the LX number in the REF*6R is not compliant, except in situations of claim or service splitting

DOCUMENT ID
005010X221