NTE

Claim Note

Pos: 190	Max: 20
Detail - Optional
Loop: 2300	Elements: 2

Ref

Id

Element Name

Req

Type

Min/Max

Usage

NTE01

363

Note Reference Code
Description: Code identifying the functional area or purpose for which the note applies

O

ID

3/3

Required

Code

Name

ADD

Additional Information

NTE02

352

Description
Description: A free-form description to clarify the related data elements and their content
Industry: Claim Note Text
NSF Reference: HA0-05.0

M

AN

1/80

Required

1.

The NTE segment permits free-form information/data which, under ANSI X12 standard implementations, is not machine processable. The use of the NTE segment should therefore be avoided, if at all possible, in an automated environment.

Notes:

1. Required when: (1) State regulations mandate information not identified elsewhere within the claim set; or (2) to report periodontal charting information.
2. If this segment is being used to report periodontal charting information, up to 6 measurements per tooth may be reported. The suggested format should be tooth number followed by a measurement for Disto-Lingual, Lingual, Mesio-Lingual, Mesio-Buccal, Buccal or Distal-Buccal. If a tooth has been extracted it should be annotated with “ext” following the tooth number.
3. Example of Charting for tooth #’s 5, 6 and 7 (extracted tooth):
#5 DL3/L4/ML5/MB4/B4/DB4, #6 DL4/L5/ML5/MB4/B4/DB5, #7 ext
4. The following information should also be reported: description of the amount of recession, indication of teeth having furcation involvement and the extent, and the diagnosis.

Example:

NTE*ADD*#5 DL4/L5/ML6/MB4, #6 L6/ML5/MB4/B5, #7 ext~