Section title: Requests for Interpretation
Authorization Numbers found in the 2300 loop v 2400 loop

Is the same destination payer's Prior Authorization Number allowed in both the 2300 and the 2400 loop?

RFI Response

Technical Report Type 3 for 837 Health Care Claim: Professional (005010X222A2) does not allow the Prior Authorization Number sent in the claim level 2300 REF*G1 to be repeated in any service line level 2400 REF*G1 within that claim. Only Prior Authorization Numbers that differ from the claim level number may be sent at the service line level. 

The situational rule for the 2400 REF – Prior Authorization segment states “Required when service line involved a prior authorization number that is different than the number reported at the claim level (Loop ID-2300).  If not required by this implementation guide, do not send.” If the service line Prior Authorization Number is not different than the claim level Prior Authorization Number, it is not required by this situational rule. And since it is not required, the rule states “do not send”.

"005010X222 005010X223"