Change Request Detail
No.
850
Date
11/11/2003
Submitter
Type of Request
Pertaining to more than one, or not sure
Status
DSMO Process Completed
Business Reason
4010X098(A1), in loop 2300, segment CRC, qualfier 07, elements 2 and 3, pages 257, 258 in the guidelines. Element 3 is the condition code related to ambulance services. Element 2 is whether the condition codes apply.

The whole segment is required if the CR1 segment us used, furthermore, element 3 is listed as required even if element 2 specifies that it is not to be used in adjudication.
Suggestion
Since condition codes may or may not be needed for adjudication, either make the segment situational, or make element 3 situational based on element 2 being a "Y". If no condition codes apply, at this point, we must require our users to enter at least one code to create a valid claim file.
DSMO Category
D
Recommendation
Disapproved.  The first three elements in the CRC segment are required in the X12 standard and the CRC segment has many other uses beyond ambulance certification.  Thus, it is not practical to change any of the first three elements in the CRC segment from Required to Situational.  The condition code of ‘60’ is provided as a value to use when no other value is suitable.
Appeal Recommendation