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Back  RFI # 441: s277 2220E SVC and STC

Formal vs. Informal Help Informal Formal

Submitter

Pat Mayes

Description

I need to verify whether the service line STC segment is required when you have a service line SVC segment. According to the IG, these are situational. We are receiving s277 reports back from one of our payers where they are sending a claim level status code for a pended claim, and also sending a service line SVC segment without the service line STC segment. One of our clients is stating that this is non-compliant, while the payer is stating this is compliant per the IG.
Thank you for your assistance.

Submitter Assigned Keywords

s277 Service Line Segments

Response

The 004010X093 guide inappropriately designated Usage for the 2220D and 2220E Loop STC Segments as Situational, rather than Required. This usage designation has caused implementation differences within the healthcare industry. However, the guide developer’s intent is that service line status (2220D/E STC Segment) is Required whenever service line information is reported. The developer’s usage intent is supported by the second note on the 2220D/E STC Segments which states "This segment is used when an information source system has the capability to provide line item information." When a payer uses the 2220D/E Loops, which begin with the SVC Segment (service line data), they have demonstrated a capability to provide line item information and the 2220D/E STC segment must be used.
Continued in Recommend section...

Recommendation

The intent is further supported in Front Matter Section 2.2.3.6, Line Item Response, where the discussion and coding example presented for a response at the service line level reflects usage of the STC Segment in the 2220D/E Loops.
This ambiguity was addressed in more recent versions, 4050 and 5010, of the 276/277 Claim Status Request and Response transaction by changing the 2220D/E STC Segment to Required when the 2220D/E Loops are used.
Submission 8/11/2006
Status Date 3/30/2007
Status F - Final
Primary References
Document 004010X093A1
Section3
Page255
Set ID277
Table2
Loop2220E
Segment IDSTC