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Back  RFI # 1331: 277CA 2200C and 2000D loops

Formal vs. Informal Help Informal Formal

Submitter

Julia Dunicheva

Description

When 2200C loop has STC segment with STC03 as 'U', what option is in compliance with the TR3 :
1. loop 2000D with patient and claim information should not be sent;
2. loop 2000D with patient and claim information may be sent to report status of specific claims.

Response

The intent of the provider level status (2200C Loop within each 2000C Loop) is to report provider level errors that caused that specific provider's group of claims to be rejected. It is not intended to be used for reporting a culmination of claim specific rejection statuses. When a Provider level status rejection occurs (2200C STC03 = U), the 2000C HL04 Code Value '0' is to be used. The HL04=0 value means that no subordinate HL Segments exist in the Hierarchical Structure related to this 'Parent HL'. Therefore the 2000D HL would not be reported.
Submission 6/10/2011
Status Date 7/22/2011
Status F - Final
Primary References
Document 005010X214
Section2.4
Page75
Set ID277
Loop2000D