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Back  RFI # 1942: Clarification STC01-1 in 277CA

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Submitter

Van Barriger Janet

Description

We have a clearinghouse sending us Health Care Claim Status Category Codes in the STC01-1 element in the 277CA transaction that are not 'A' and 'E' codes. Can you please clarify if Health Care Claim Status Category Codes that start with 'F', 'P' or 'R' can be sent in the 005010X214 transaction STC01-1 element in the 2200B or 2200D loops?

Submitter Assigned Keywords

Claim Status Category Codes 277CA STC01-1

Response

This issue is explicitly addressed in guide 005010X214. The STC01-1 element note in loops 2200B and 2200D reads:

“For this business application acknowledgment, use of the Claim Status Category Code is limited to category types ‘A’ for batch. For real time acknowledgements category types ‘A’ and ‘E’ may be used except for E0. Use of the category type ‘E’ is limited to indicating the business application system is unavailable.”

Use of category codes ‘F’, ‘P’, and ‘R’ in the STC01-1 for loops 2200B and 2200D is not compliant with the TR3.

Recommendation

To review X12's position on the action to take in regard to the receipt of non-compliant transactions, please see RFI 1512.
Submission 6/17/2014
Status Date 7/17/2014
Status F - Final
Primary References
Document 005010X214
Section2.3
Page50
Set ID277CA
Table2
Loop2200B
Segment Position1000
Segment IDSTC
Element Position01
Component Position1
Industry NameClaim Status
External Code List507
Code Value'F'