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CMS-1500 Paper Claim Form Crosswalk to EMC Loops and Segments Claims submitted to NAS for payment are submitted in two different formats paper CMS-1500 Claim Form and electronic ANSI 410A1 electronic media claim EMC. Many articles published by CMS and NAS contain references to paper claim fields by noting an Item number such as Item 19 or Item 24e. These specific item numbers can be referenced in the crosswalk below for the correct placement on E.

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Each individual loop on an electronic claim has a segment component where the data is entered. The loops and segments contain the readable information that provides the clearinghouse the identifying information for the claim that was filed.

The loops and segments contain the readable information that provides the clearinghouse the identifying information for the claim that was filed. The loops on an electronic claim are organized by categories of information that match data elements on the CMS-1500 claim form.

CMS-1500 Claim Form Crosswalk to EMC Loops and Segments CMS-1500 Form ItemCMS-1500EMC ANSI 837 Loop17BReferring/Ordering2310A (referring) 2420E (ordering) 2310D (supervising)18Hospitalization Dates Related to Current Services230019Reserved for Local Use (Commentary and Narrative)230020Outside Lab Charges240061 more rows • Oct 28, 2022

A block or section of an EDI file is called a Loop. Each loop contains several different Segments, which are comprised of Elements and Sub-Elements. Although Loops are the biggest component in an EDI, they are often the hardest to distinguish. They will typically begin with an HL or NM1 Segment.

Box 23 is used to show the payer assigned number authorizing the service(s).

OfficeMate. Details. If you are receiving a "Loop 2400 Loop NTE" claim rejection notice from your insurance company when you are submitting ANSI insurance claims from OfficeMate, the clearinghouse/carrier is not receiving the Notes for the CPT billed on the claim.

Loop 2000B - Subscriber. Loop 2300 - Claim Information. Loop 2400 - Service Line Information. Secondary Payer Format. Loop 2310B - Rendering Provider.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232