Change Request Detail
No.
836
Date
8/18/2003
Submitter
Type of Request
Claim Status Request and Response
Status
DSMO Process Completed
Business Reason
On page 210 of the implementation guide, the Payer claim identification number in the dependent loop is a required segment.  However, if a provider sends us search criteria other than the claim number and we do not find any matches in our system, what information should we respond with?  We would have to input dummy data into the claim identification number because we would not have one.
Suggestion
The suggested change is to make the segment situational.

Payer Claim Identification Number (2200E). Page 210.
DSMO Category
D
Recommendation
Disapprove.  For Version 4050 and beyond, Loop 2200E Payer Claim Identification Number REF has been made Situational. However, in order for the requestor to meet the current syntactical requirements of Version 4010A1, we recommend using a zero (0) in element REF02 when a claim number can not be found or echoback the same number reported in the 276, if one was submitted.
Appeal Recommendation