The simple answer is that you cannot return tooth number, tooth surface and/or oral cavity area information in the 835 Payment/Remittance Advice transaction. It does not matter whether the inbound 837 is a claim or a predetermination; the 835 can only return the information available in the SVC segment.
If the inbound claim or predetermination contains a Line Item Control Number in the Line Item Loop (see the Line Item Control Number - REF*6R -- segment in the 2400 loop), then the health plan MUST return that identifier in the 835. The 835 contains the Service Identification segment at the line item level. One of the potential uses for this segment is to return the Provider Control Number (REF*6R). The element note for this option is as follows: "This is the Line Item Control Number submitted in the 837, which is utilized by the provider for tracking purposes, if submitted on the claim this must be returned on remittance advice." The provider would then use the Line Item Control Number to match the information in the 835 to the original claim or predetermination. Hope this helps. Tom Drinkard EDIT, Inc. (678) 795-1251 -----Original Message----- From: [EMAIL PROTECTED] [mailto:rxthukr@;regence.com] Sent: Monday, October 21, 2002 9:32 PM To: [EMAIL PROTECTED] Subject: Dental Pre-Estimates (835) - Tooth Number We have an 835 Dental Pre-estimates question that hopefully someone out there can help us with. Do any of you know where we can return the tooth identification information? On the inbound 837-D the tooth identification area includes the tooth number as well as the tooth surface. These are existing fields on the NSF. Particularly the tooth number is important in explaining to the submitter how our estimates should be applied to the work in question. Thanks much... Thuky [EMAIL PROTECTED] 206.287.5418 =========================================================================== IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should delete this message and are hereby notified that any disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
