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Formal vs. Informal Help Informal Formal


Daniel Sawyer


Is it permissable in HIPAA 278 transactions to use the repeats of PWK and MSG Segments in order to transmit free text that can then be strung back together by the receiver to form longer free text content (e.g., repeat PWK for its allowed 10 times so the 10 PWK07 Data Elements add up to 800 characters). Another example posed was repeating the 2000F Loop so that multiple MSG Segments could be sent with 264 characters (one MSG Segment with 264 characters in multiple 2000F Loops). Ultimately looking for places or ways in the 278 to transmitted larger amounts of free text.
- Need a definitive answer (and reference) as to whether utilizing repeating Loops and/or Segments in order to gain more free text is allowable in a HIPAA 278 transaction set? Need to make sure there is no question as to whether it is "allowed".
- Are you aware of an allowable alternative within HIPAA 278 that would maximize free text that can be sent (assuming that the sender and receiver are working together toward using this free text)?


This is explicitly addressed in guide 004010X094A1. Section states about the PWK "This enables the requester to attach up to 10 items pertaining to the patient’s condition and/or up to 10 items pertaining to each occurrence of Loop 2000F of the request". Applying to 10 items precludes using the PWK 10 times to apply to 1 item.

The MSG segment occurs only once within the 2000F loop. Information in one loop is specific to that loop and has no relation to other loops at the same hierarchical level. It only applies to the provider specific to that loop. Therefore, MSG information within multiple loops can not be concatenated into a single, longer, message.


Workgroup suggests putting all related information in one document and use the PWK segment to reference that document. You could additionally use the MSG segment to add an explicit comment stressing the importance of the document referenced in the PWK segment.
Submission 4/5/2005
Status Date 6/13/2005
Status F - Final
Primary References
Document 004010X094A1
Set ID278
Segment IDPWK
Element Position07