"According to the X12 837I Implementation Guide, for SV203 (Line Item Charge Amount) it states that “Zero "0" is an acceptable value for this element.” In a payer’s companion guide, they have a requirement stating “The Service Line Charge Amount (2400 | SV203) must be a numeric and greater than zero.”
In accordance with the companion guide requirement, this payer had their clearinghouse put an edit in place that would reject claims that were billed with a service line charge amount equal to zero. The payer further states that if they have their clearinghouse bypass this edit, that claims will still not be allowed into their adjudication system due to their business edit.
Is it complaint for the clearinghouse to uphold this edit?
If the clearinghouse bypasses this edit is the payer being compliant with their business practices?
It is compliant with the guide to submit a zero in the 2400 SV203.
Companion guides may not add, modify or delete any requirements, including loop, segment or element names, notes or rules, examples, appendix, or code list subsets from Section 2 of the associated TR3. For more information on companion guides please see the ASCX12 Intellectual Property statement at http://store.x12.org/store/ip-use.