As a further clarification of RFI #2280, for the version 005010 Loop 2310C NM1 segment Situational Rule, could you please define precisely what the word "different" means in this context? Here is the complete Situational Rule: "Required when the location of health care service is different than that carried in Loop ID-2010AA (Billing Provider). If not required by this implementation guide, do not send."
Would two locations be considered different if there is even a single character mismatch between the Loop 2010AA versus 2310C N3 and N4 field values, or are payers allowed to do some level of address standardization/normalization when comparing to determine whether Loop 2310C was sent appropriately as per the Situational Rule? For example, if the N3 and N4 segments are identical across those two loops except that one has N301 = "123 W MAIN ST" and the other has N301 = "123 WEST MAIN STREET" would those be considered the same or different, or is it up to the payer?
A provider is submitting an 837P professional claim and needs to include a service facility location with an NPI different from the billing provider. They want to ensure that the payer will not reject the claim based on the Loop 2310C Situational Rule.
The implementation guide is not specific as to the definition of "different." It would be up to the payer to decide if addresses are different and thus some level of address standardization/normalization would be allowed.
Allow payers to decide what constitutes a different address. Future versions of the guide may want to include guidance on "different."