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Back  RFI # 600: Zip Code Validation

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Submitter

Greg Dawson

Description

Using 004010x096 (4010a1 837) is it a valid compliant action to deny a claim that does not contain a full 9-digit zip code in N403?

Using the code validation from the USPS as referenced in the IG, surely a claim submitted with a five digit zip-code is considered as compliant. Restricting claims submission to only use of a 9-digit zip-code would therefore be considered non-compliant processing.

Submitter Assigned Keywords

zip-code validation

Response

This issue is explicitly addressed in guide 004010X096. The data element for all N403 locations references code source 22 as the defining agency (See Appendix C). That code source references the US Postal Service (USPS). Since the USPS defines the ZIP Code in both the 5 digit and 9 digit formats, either is acceptable from a guide compliance perspective. Trading partner needs for processing would be determined by a companion guide, which could identify a specific trading partner's need to receive a 9 digit ZIP Code. See section 1.1.1. In that case, 5 digits could not be rejected as non-compliant, but could result in the inability of the receiver to process the business transaction - in this case, to process the institutional claim.
Submission 8/29/2007
Status Date 8/31/2007
Status F - Final
Primary References
Document 004010x096
Section3.1
Page81
Set ID837i
Loop2010
Segment IDN4
Element Position03