Section title: Requests for Interpretation
RFI #
2190
837P 2310D without 2310B
Description

According to the 837P TR3, the 2310D Supervising Provider is situationally required when the rendering provider is supervised by a physician. Is it allowed to require a 2310D but not allow the 2310B Rendering loop?

RFI Response

It is compliant to submit a 2310D supervising provider and a 2310B rendering provider on the same claim. It is also compliant to submit a 2310D supervising provider without a 2310B rendering provider. It is not complaint to require that the 2310D supervising provider be submitted without a 2310B rendering provider.

The 2310B Rendering Provider Loop is required when the rendering provider information is different from that reported in the 2010AA Billing Provider Loop. The 2310D Supervising Provider Loop is required when the rendering provider is supervised by a physician. Submission of the 2310D Supervising Provider Loop is not dependent on the presence or absence of the 2310B Rendering Provider Loop.

The individual practitioner that rendered the services is reported in the Billing Provider Loop 2010AA only “when the services were performed by, and will be paid to, an independent, non-incorporated individual”. (Section 1.10.3) The individual practitioner that rendered the services is reported in the Rendering Provider Loop 2310B when the Billing Provider is a group and the individual is part of that group. (Note: The individual may also be reported in the Rendering Provider Loop 2420A when they are different than the Rendering Provider reported in 2310B OR 2310B was not reported and they are different than the Billing Provider reported in 2010AA).

When the rendering provider was supervised, the supervising provider is reported in the Supervising Provider Loop 2310D or in the Supervising Provider Loop 2420D when the supervising provider is different than the one reported at the claim level for the service line.

DOCUMENT ID
005010X222