The "IL" qualifier for the NM1 segment denotes the Insured Subscriber. I have ""QB" mapped to independent Lab flag. The charges are then in Segment PS1 as you mentioned. PS1 02 should probably be the same as NM1 09 with the QB qualifier. A "TL" qualifier just specifies the service location for Box 32 on the HCFA-1500.
Martin Scholl Scholl Consulting Group, Inc. 301-924-5537 Tel 301-570-0139 Fax [EMAIL PROTECTED] www.SchollConsulting.com > I have seen a cosswalk from the HCFA1500 to the 837. When referencing box > 20 "Outside Lab Yes/No and Charges", it was not clear how these should be > mapped. So, I would like to ask if the following then could be considered > correct: > > In Loop ID - 2310D Service Facility Location, outside lab will be > identified by the identifiers on the NM1 segment. > > If the NM101 Entity Code is "IL", this will indicate that the "Outside Lab > is Yes". For these transactions, a PS1 segment will be required in loop > 2400 to disclose the charges to be reported in box 20 "Charges". > > If the NM101 Entity Code is "TL", this will indicate an affiliated "Testing > Laboratory", so, box 20 "Outside Lab is NO". No PS1 segment will not be > required because charges are not required when Outside Lab is NO. > > > > Bob Ford > [EMAIL PROTECTED] > 401-822-1962
