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Back  RFI # 2172: EQ01/EB03 Compliant Code Use

Formal vs. Informal Help Informal Formal

Submitter

Joe Stanton

Description

We are HIPAA Covered Entity that is currently exchanging the ASC X12N 5010 X279 270/271 transactions with several other Covered Entity trading partners. With respect to compliant code use of the 270 EQ01 (1365) and 271 EB03 (1365) data elements, we are aware of (and would like to consider the use of) some of the new Service Type Codes as defined in the recently updated external code list: ASC X12 External Code Source 958.
Although some of these new codes are 3 characters and exceed the 2-character length restriction defined in the 5010 guide, we would consider a temporary solution of mapping the 3-character codes to some 2-character codes that are not otherwise being used within our specific sector of healthcare until such time that a newer version of the TR3 is adopted for use.
Can this approach be considered with willing trading partners?

Submitter Assigned Keywords

EQ01 EB03

Response

For version 5010, data element 1365 used in the EQ01 and EB03 of the 270, and 271 respectively must be populated with a valid code from the internal code list in the 005010X279A1 TR3. Health Care Services Type Codes • ASC X12 External Code Source 958 is available for version 6020 and greater only.

Recommendation

Use of a suitable existing EQ01/EB03 code from the 005010X279A1 TR3 could be used in conjunction with the MSG segment (element MSG01) providing the additional appropriate information about the service.
Submission 9/15/2016
Status Date 11/21/2016
Status F - Final
Primary References
Document 005010X279
Section2.4 2.6
Set ID270 27