Hi,
I'm having a problem understanding some compliancy issues regarding COB rules.
in the 4010a 837P the 2430 SVD01 says "SVD01 identifies the payer which adjudicated the corrsponding service line and must match DE 67 in the NM109 position 325 for the payer"
the problem is the word 'corresponding' because if you see below we have a situation where we have 2 payers and then 2 SVD's for each LX so the SVD won't ever match up 1-to-1 with the NM109 hence the compliance error??
Is the data just structured incorrectly? or is it a compliancy issue?
BTW: this is sample data
thanks
Bill Swaney
HIPAA Consultant
NM1*PR*2*SMITH*****PI*9012345918341~
CLM*2.1.2.4*2100.00***23::1*Y*C*Y*N~
HI*BK:41030~
SBR*P*19*28161*CARPENTER KAREN*C1****CI~
CAS*PR*1*10.00~
DMG*D8*19630601*F~
OI***Y*C**Y~
NM1*IL*1*NIXON*RICHARD****MI*527471882~
NM1*PR*2*payer name*****PI*101~
SBR*S*19*398161*STEEL S UNION*C1****CI~
CAS*PR*1*10.00~
DMG*D8*19630601*F~
OI***Y*C**Y~
NM1*IL*1*NIXON*JANE****MI*527471999~
NM1*PR*2*payer name*****PI*027~
LX*1~
SV1*HC:93501*1000.00*UN*1***1~
DTP*472*D8*20021018~
SVD*101*0*HC:93530**1*2~
DTP*573*D8*20021202~
SVD*027*0*HC:93530**1*2~
DTP*573*D8*20021202~
LX*2~
SV1*HC:93530*900.00*UN*1***1~
DTP*472*D8*20021018~
SVD*101*950*HC:93530**1~
CAS*PR*1*10.00~
DTP*573*D8*20021202~
SVD*027*150*HC:93530**1~
DTP*573*D8*20021212~
LX*3~
SV1*HC:93503*200.00*UN*1***1~
DTP*472*D8*20021018~
SVD*101*0*HC:93530**1*2~
DTP*573*D8*20021202~
SVD*027*0*HC:93530**1*2~
DTP*573*D8*20021212~
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