Section title: Requests for Interpretation
Interpretation of Situational Rule 2310E Service Facility Location Name & TR3 Note (837I)

Per scenario below, is L2310E required to be populated


XYZ Hospital owns off-site Practice location. Off-site location has its own NPI. Patient is seen for office visit and blood is drawn for Labs. Blood is sent to XYZ Hospital to process for Lab results. For the 837I (UB) claim, the Billing Provider is XYZ Hospital, and the Service Facility is the off-site Practice location < billing is for the Lab processing>. Is this correct when patient's lab is being processed but patient did not present to main hospital?

The Billing Provider is XYZ Hospital, and the Service Facility is a clinic that XYZ Hospital owns. XYZ hospital has its own NPI, all XYZ hospital clinics have their own NPI. The clinic is off-site from the hospital. Transaction in question is for the blood processing/analysis and not for the draw.

RFI Response

Both the front matter sections 1.10.3, 1.10.4 and the 2310E NM1's TR3 Note indicate that it is not permissible to report an NPI as the Service Location if it is a subpart of the Billing Provider.

\Based on the information given in the business scenario, the service location is a subpart of the Billing Provider, therefore loop ID 2310E would not be reported.