Section title: Requests for Interpretation
RFI #
1975
837I, PCP group, Inpatient
Description

Is there any way in the 837I claim to report a Referring Provider that is not a person but is a group on an inpatient claim?

RFI Response

Submitting a group as a referring provider is not supported by the 5010 837I.

The claim level referring provider entity type qualifier located at 2310F NM102 only allows for value of “1” which indicates person. The 2420D line level referring provider includes the same restriction. In order to submit a group a value of “2” non-person would need to be a allowed value.

If you wish this functionality included in a future version of the guide a change request will need to be filed including the business case. More informaiton on change request can be found at http://www.hipaa-dsmo.org/ http://changerequest.x12.org/

DOCUMENT ID
005010X223 - wording clarified after conversation with the submitter and with submitter agreement.