AMT

Coordination of Benefits (COB) Approved Amount

Pos: 300

Max: 1

Detail - Optional

Loop: 2320

Elements: 2


User Option (Usage): Situational
To indicate the total monetary amount

Element Summary:

 

Ref

Id

Element Name

Req

Type

Min/Max

Usage

 

AMT01

522

Amount Qualifier Code
Description: Code to qualify amount

M

ID

1/3

Required

 

Code

Name

 

AAE

Approved Amount

 

AMT02

782

Monetary Amount
Description: Monetary amount
Industry: Approved Amount
NSF Reference: DA1-27.0

M

R

1/18

Required



Notes:

1. Used only in payer-to-payer COB situations by the payer who is sending this claim to another payer. Providers do not complete this information.
2. The approved amount equals the amount for the total claim that was approved by the payer sending this 837 to another payer.

Example:

AMT*AAE*500~



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