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Back  RFI # 1752: 276/277 Status for Paper Claim

Formal vs. Informal Help Informal Formal

Submitter

Scott Cheatham

Description

If the 277 Health Care Information Status Notification (005010X212) is used to respond to a 276 Claim Status Request and the claim involved was originally submitted as a paper claim, how should the value of REF02 Bill Type Identifier in loop 2200D (REF01="BLT") be formatted?
Can it mimic the value from the paper claim, i.e. have a leading zero, like "0131"?
Or should it be sent without the leading zero as if the origninal claim had been submitted electronically, like "131"?

Response

The 005010X212 guide defines the2200D/E Bill Type Identifier (REF02, where REF01=BLT) as the concatenated value of the Facility Type Code (CLM05-1) and the Claim Frequency Code (CLM05-3) of the 837. Since the CLM05-1 sub-element has a maximum of 2 bytes and CLM05-3 has a maximum of 1 byte, and to maintain consistency between the electronic transactions, the Bill Type Identifier in the 2200D/E of the 005010X212 would be reported as a 3 byte value (e.g. 131).
Submission 2/13/2013
Status Date 3/29/2013
Status F - Final
Primary References
Document 005010X212
Section2.6
Page150
Set ID277
Loop2200D
Segment IDREF
Element Position02
Industry NameBill Type Identifier