For claims with a place of service code of 81 (independent lab) in the clm05-1 element, how would service location be defined? For purposes of defining where service location is for use in the 2310C loop, would the location of the specimen draw or the location where the lab was processed be considered the service location?
This issue is explicitly addressed in Guide 005010X222A1. TR3 note 2 of the 2310C Loop reads in part as follows, “The purpose of this loop is to identify specifically where the service was rendered.” However, the 2310C loop is only “Required when the location of health care service is different than that carried in Loop ID-2010AA (Billing Provider).” Therefore, if the Independent Lab is the Billing Provider and the location of the service(s) is the same as that reported in the 2010AA Loop the 2310C must not be sent.
The service facility location is related to each specific service. If the service location is different than that reported in the 2010AA loop, then the 2310C loop is required. If the specimen draw is the only service being billed, then the service facility location is the location where the specimen was drawn. If the processing of the specimen is the only service being billed, then the service facility location is the location where the specimen was processed. If both services are being billed in the same claim, and the service locations are different than that reported in the 2010AA loop, and both services were rendered in the same location then that location is reported in the 2310C Loop. If the specimen draw and processing of the specimen are billed in the same claim and were rendered in different locations, one location would be reported in the 2310C Loop, and the other location would be reported in the 2420C Service Facility Location of that service.