Element Requirements Table

The North Carolina Industrial Commission Medical Element Requirement Table, worksheet labeled ‘837 Medical Requirements’, provides the medical business and technical data element requirements based on Report Type(s) established on the Medical Event Table. Refer to the Medical Edit Matrix for the edits that will be applied based on the data element requirements. 

As part of the Medical Element Requirement Table, Medical conditional data elements are included in the worksheet labeled ‘837 Medical Conditions’. These conditional data elements are normally optional but become mandatory or expected under conditions established by the jurisdiction. If the defined condition exists, the data element becomes mandatory, and the corresponding rules apply. For Mandatory/Conditional data elements, the data element must be present and must be a valid format or the transaction will be rejected.