UTN Field Requirements for Prior Authorization - JE Part A

For all Medicare Part A providers submitting electronic claims, the Medicare Treatment Authorization field must contain blanks or valid Medicare data in the first 14 bytes of the treatment authorization field at the loop 2300 REF02 (REF01=G1) segment for the ASC X12 837 claim. Institutional claims submitted without blanks or valid data will be rejected. These claims will need to be corrected and resubmitted.

Valid Unique Tracking Number (UTN) data in the loop 2300 REF02 (REF01=G1) segment for the ASC X12 837 claims is as follows:

• The first two positions of UTN must be alpha-numeric and cannot contain spaces.
• The third position of UTN is an A or H.
• The last 11 positions of UTN must be numeric and cannot contain spaces.

Examples of valid data:

• Trial 49
• SPN66
• 64
• 56
• A/B Rebilling
• 54
• SPN65
• 07
• 08