Section title: Requests for Interpretation
RFI #
1857
2300 CLM06 for 837I
Description

For 5010 2300 CLM06 is listed as not used for Institutional claims but is still used for professional claims.
Why is there a difference? Also I noticed that the change from used to not used is not mentioned in the Change summary of the TR3 and in the TR3 example of the CLM segment the CLM06 is still shown as being used. Just making sure that this field was not changed to not used in error.

RFI Response

Two different committees are responsible for content in these transactions. The National Uniform Billing Committee (NUBC) is responsible for the content of institutional claims. The National Uniform Claims Committee (NUCC) is responsible for the content of professional claims.

Based on input from their constituencies, the NUBC and NUCC made independent decisions related to the necessity of the Provider or Supplier Signature (2300 CLM06), with NUBC determining that it was no longer required on institutional claims (effective with the UB04 update) and NUCC determining that the information is still necessary for professional claims. ASC X12 revised the requirements of the 005010 TR3s accordingly.

If more information related to the NUCC and/or NUBC decisions is needed, please contact those organizations directly as ASC X12 is not able to provide detailed explanation of decisions made by those committees.

The fact that this was not noted in the version 005010X223 Change Summary was an oversight. Please note that the segment level example is 005010X223 is incorrect. The correct example for this segment is CLM*12345656*500***11:A:1**A*Y*I~.

DOCUMENT ID
005010X223