Section title: Requests for Interpretation
RFI #
2790
2000E/2000F PWK Segment Repeat Upper Limit 10 (278)
Description

If there is a need to submit more than 10 Attachment Control Numbers in 2000E (Patient Level) PWK06 in connection with their electronic 275 attachments, given that the PWK segment only repeats 10 times, how should this be handled? Can 2000F (Service Detail) PWK serve as overflow for this purpose?

Scenario

More than 10 relevant clinical documents are required as evidence with an unsolicited request for authorization. There is not an option to reference more than 10 control numbers for those respective documents in PWK06 of the 005010X217 278, given that the segment repeat is 10.

RFI Response

The 005010 implementation guide only supports 10 repeats of the PWK segment, if the 2000E loop is utilized.

RFI Recommendation

The submitter needs to work with the payer(s) for their expectations, even when unsolicited. It is not within X12's purview to clarify this when the 005010 TR3 does not address it. 

If this is functionality that is needed for your business and not currently supported in a published TR3, submit an X12 maintenance request at https://x12.org/resources/forms/maintenance-requests.

DOCUMENT ID
005010X217