Change Request Detail
No.
869
Date
4/7/2004
Submitter
Type of Request
Institutional Claim (UB-92)
Status
DSMO Process Completed
Business Reason
We would like to store Note type information in the claims detail level to communicate how a particular claim was repriced.  The current codes for claims processing are too generic and we are requested by our clients to populate more information.  This change was added in the 837 4010A1 for the Prof Claims, we would like the same for the Inst. 
Suggestion
Add a note segment in the claims detail part of the 837 4010 INST. like the prof has (I would like to be consistant)

Loop 2400 Service Line Information
NTE Segment - Line Note    Min 1, Max 1  (BSC Custom Reason Codes)

Note Reference Code    NTE01    Note Reference Code "ADD" = Additonal Information
Description    NTE02    Line Note Text (Beech Street Custom Reason Codes)

Please contact for more information
DSMO Category
B
Recommendation
Approve. The DSMO agreed with the addition of the NTE for the purposes of repricer needs. X12N (Task Group 2 Work Group 2 Health Care Claims) will work on providing the situational notes and usage for repricers. The DSMO encourage the repricing organizations to collectively determine a standardized approach to represent their needs.
Appeal Recommendation