Change Request Detail
No.
1137
Date
2/3/2011
Submitter
Type of Request
Pertaining to more than one, or not sure
Status
DSMO Process Completed
Business Reason
simplification and reduced cost
Suggestion
Have Institutional, professional and dental use the same specs. there are definite differences in needed loops and segments, but simply do not use those that are not needed.

Example (v5010 837)
Professional: 2420C is service location qualifier 77
Dental: 2420C is payer qualifier PR
Institutional 2420C is rendering provider qualifier 82

These differences create the need for at least 3 different sets of code, different error detection, different pre-pass edits. Many things that increase cost and complexity for no reason.
DSMO Category
D
Recommendation
Disapprove.
Creating the same loop ID's across TR3's will not eliminate the need to edit for loop, segment and element conditions.

It is important for implementers to understand loops or segments that share the same position number in the standard are considered peers of each other and may be presented in any order in a transaction. The alpha representation (2010AA, 2010AB, etc) exists only to provide a more comprehensive view of the transaction.
Appeal Recommendation