NM1

Responsible Party Name

Pos: 015

Max: 1

Detail - Optional

Loop: 2010BD

Elements: 6

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	NM101	98	Entity Identifier Code Description: Code identifying an organizational entity, a physical location, property or an individual	M	ID	2/3	Required

Code

Name

Responsible Party

Description: Person responsible for the affairs of the person having services rendered

NM102

1065

Entity Type Qualifier
Description: Code qualifying the type of entity

1/1

Required

	Code	Name
	1	Person
	2	Non-Person Entity

NM103	1035	Name Last or Organization Name Description: Individual last name or organizational name Industry: Responsible Party Last or Organization Name	O	AN	1/35	Required
NM104	1036	Name First Description: Individual first name Industry: Responsible Party First Name Required if NM102=1 (person).	O	AN	1/25	Situational
NM105	1037	Name Middle Description: Individual middle name or initial Industry: Responsible Party Middle Name Required if NM102=1 and the middle name/initial of the person is known.	O	AN	1/25	Situational
NM107	1039	Name Suffix Description: Suffix to individual name Industry: Responsible Party Suffix Name Alias: Responsible Party Generation Required if known.	O	AN	1/10	Situational

Notes:

1. In general terms, the responsible party is someone who is not the subscriber/patient but who has financial responsibility for the bill.
2. Because the usage of this segment is �Situational� this is not a syntactically required loop. If this loop is used, then this segment is a �Required� segment. See Appendix A for further details on ASC X12 nomenclature.
3. Required for Medicare claims where there is no authorized representative and the provider of medical services has neither the responsible party�s signature nor the patient�s signature on file.

Example:

NM1*QD*1*JONES*LISA~

1.	P0809 - If either NM108,NM109 is present, then all are required
2.	C1110 - If NM111 is present, then all of NM110 are required