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Back  RFI # 1360: 837D 5010 Zip + 4 workaround

Formal vs. Informal Help Informal Formal

Submitter

Teresa Mika

Description

Is there an acceptable workaround if you are sending an Encounter transaction and only have a 5 digit ZIP code for a Billing Provider? Can the 5 digit ZIP code be padded with zeroes or with 9998? Also, we often deny claims, but still need to report them, when providers do not supply address information. In that case, is it acceptable to send a ZIP code like 999999999?

Submitter Assigned Keywords

837D, ZIP + 4

Response

It is appropriate to use the “9998” in the last four digits of the zip code field; however, it is not acceptable to use zeros or 999999999.
Submission 7/21/2011
Status Date 9/23/2011
Status F - Final
Primary References
Document 005010X224
Section2.3.1
Page88
Set ID837D
Table2
Loop2010AA
Segment Position0300
Segment IDNM4
Element Position03
Industry NameBilling Provider Postal Zone or ZIP Code
External Code List51, 932