Section title: Requests for Interpretation
How should donor claims be submitted?

TR3 states to use qualifier of 39 or 40 for donor/transplant on loop 2000C. Does this mean the donor information should be populated on 2010CA and recipient information on 2010BA?


Our system is matching the donor information as the patient due to the patient loop being populated.

RFI Response

2000C PAT01 is the Patients Relationship to the person Insured. The TR3 does not speak to policy on how to report the Donor or Recipient specifically.

RFI Recommendation

You may submit an ASC X12 change request it, if there is a business need not supported in a published TR3, for consideration in a future version of the TR3.

005010X222, 005010X223,