ANSI X12 837P - 4010 2010BB REF - Payer Secondary Identification

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May 19, 2020

The 2010BB REF Payer Secondary Identification Segment is required if additional identification numbers are required to adjudicate the claim. The 4010 specifications for the REF segment can be found below as it pertains to the 2010BB loop.

Sample 837P (4010) - 2010BB REF - Payer Secondary Identification

> Payer Name (2010BB) REF*FY*987654321~

HIPAA Guide - 837P [4010]

[Situational]

Segment Field Name Definition
REF01Reference Identification Qualifier
CodeDefinition
2UPayer Identification Number Used to identify any payer
FYClaim Office Number
NFNational Association of Insurance Commissioners (NAIC) Code
TJFederal Taxpayer's Identification Number
REF02Reference Identification
REF03Description
REF04Reference Identifier

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