Section title: Requests for Interpretation
837i 5010 2310D confusion

In the documentation for the “005010X223 • 837 • 2310D • NM1 ASC X12N • RENDERING PROVIDER NAME”  it states

Required when the Rendering Provider is different than the Attending Provider reported in Loop ID-2310A of this claim.


When  state or federal regulatory requirements call for a “combined claim”,  that is, a claim that includes both facility and professional components (for example, a Medicaid clinic bill or Critical Access Hospital Claim.)

The question is:  Does that “AND” mean “OR” (meaning: if either half is true, 2310D should be included) or does it truly mean “AND” (meaning: only include 2310D if both requirements are met)?

RFI Response

The situational rule truly means “AND.”  Both requirements must be met. 

Related RFIs:     1902,  1953, 1952