Section title: Requests for Interpretation
RFI #
2151
CPT04 Units for the 837I and 837P
Description

How should we expect to receive inpatient Discharge Dates? What is expected to happen in future versions?

RFI Response

The convention for reporting the NDC on paper claim forms does not apply to electronic claims. In the 837 claim transactions, the information is reported in discrete data elements and it is not necessary for the TR3 to describe a convention for sending multiple elements in one position.

The NDC code Qualifier is sent in data element LIN02 using a value of "N4", the NDC code is sent in data element LIN03, the drug quantity is sent in data element CTP04, and the unit or basis of measurement code is sent in data element CTP05-01; all of which are in Loop ID 2410 in both the 837 Professional and 837 Institutional claim transactions.

RFI Recommendation

For information related to the formating of the value populated in the CTP04 National Drug Unit Count, please see RFI #1924.

DOCUMENT ID
005010X223