RFI #
2198
Loop 2000C PAT01 Valid Values
Description
A payer is requiring a value of "11" to represent organ donor in Loop 2000C, PAT01 (patient relationship to insured) for inpatient transplant claims. This is not a valid value per the 5010 ANSI TR3 guide.
Please advise if the payer's requirement is non-compliant with ANSI standards to require providers to enter a value that is not provided in the code list in the TR3. The correct value for organ donor is 39, and therefore is the value the payer should be requiring/accepting.
RFI Response
It is not compliant with the 5010 837I TR3 to submit a value of 11 in the loop 2000C PAT01. The correct value for organ donor is 39
DOCUMENT ID
005010X223