Question

#17 ebrind30hm
ref18h1234 567
dtp307d8*20000601
ref1l54321
ref1w987654321
ls*2120
nm1prp2generic com medicare advantage***sv02

based on the lines in the x12 message above, which of the following searches will return information about the payer?

select one of the following (3 pts)
a. ref01 equals 1l
b. nm101 equals prp
c. ref01 equals 18
d. ref01 equals 1w

Explanation:

Identify the segment containing payer information

The X12 message contains several segments: EB, REF, DTP, LS, and NM1.
The segment containing the payer's name ("GENERIC COM MEDICARE ADVANTAGE") is:
NM1PRP2GENERIC COM MEDICARE ADVANTAGE***SV02

Analyze the NM1 segment elements

In an X12 NM1 segment, the elements are delimited by asterisks (*):

• NM1 is the segment identifier.
• NM101 is the first element: PRP (which stands for Payer).
• NM102 is the second element: 2 (Non-Person Entity).
• NM103 is the third element: GENERIC COM MEDICARE ADVANTAGE (Organization Name / Payer Name).

Match with the search criteria options

To locate or return information about the payer from this segment, the search needs to target the NM1 segment where the entity identifier code in NM101 represents the payer (PRP).
Therefore, the correct search criteria is NM101 Equals PRP.

Answer:

• (A) REF01 Equals 1L
• (B) NM101 Equals PRP (Correct answer)
• (C) REF01 Equals 18
• (D) REF01 Equals 1W