Not Required or Not Used

For Medicare electronic claims, we don’t require you to complete data elements shown in Table 4. But other payers may require them.

Don’t use these data elements on paper claims. You can’t submit them to any payer.

Table 4: Data Elements Medicare Doesn’t Require

Description	837P Loop
Item 15 – Other Date QUAL.	Loop 2300 DTP01, DTP03
Item 17a – Other ID Number	Loop 2310A, 2310D, or 2420E REF01, REF02
Item 22 – Resubmission Code	Loop 2300 CLM05-3
Item 24C – EMG (Emergency)	Loop 2400 SV109
Item 24H – Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Family Plan	Loop 2400 SV111, SV112
Item 24I – Identification (ID. QUAL.) Qualifier	Loop 2310B PRV02, REF01 or 2420A PRV02, REF01
Item 32b – Service Facility Other ID Number	Loop 2310C REF01, REF02
Item 33b – Billing Provider Other ID Number	Loop 2010AA REF01, REF02

We’ll now review the claim information relevant to health care professionals or suppliers.