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ASC X12 Requests for Interpretation

This browser provides access to information related to the meaning, use, and interpretation of ASC X12 Standards, Guidelines, and Technical Reports, including Technical Report Type 3 (TR3) implementation guidelines. The information is available in the form of responses to questions submitted by implementers of the ASC X12 products.

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ASC X12 interpretations are limited to the listed ASC X12 products. ASC X12 does not comment on the actions, requirements or publications of other entities including regulatory bodies, industry groups and other SDOs. ASC X12 does not render opinions on an individual entity's compliance with any federal or state regulations.

ASC X12 assumes no duty or obligation under law to any user or requester of information, which maintain the legal responsibilities to comply with the applicable laws. ASC X12 is not liable for any loss, damage, injury, claim, or otherwise, whether an action in contract or tort, with respect to any information or content from this portal and are further not liable for any lost profits, or direct, indirect, special, punitive, or consequential damages of any kind (including without limitation attorneys' fees and expense).

667 Multiple Interchange Envelopes
848 270/271 Ou of Pocket
878 834 Medicare Effective Dates
881 OOP Response Formatting
886 Definitions of DTP codes
893 Using Repeating Data Element
894 Not using Repeating Elements
895 270/271 colonoscopies coding
898 005010X279-271-EB3 Repeat
907 Medicaid EPSDT Indicator Usage
908  837P 5010 Situational notes
913 837D 5010 Request for K3 Use
914 HIPAA 5010 835 requirements
918 270 5010 DTP Segment Use
922 270 2100D INS
923 271 X279 Other Payer reqt
924 Release of information
925 Use of EB11 (271 2110C/D)
930 COBRA Continuation Coverage
931 2400 LOOP SV107 - 2 - 4010
933 Clarification request, #802
941 HCR in 5010X217
942 278 Response 5010X217
943 278 2000F Loop Limit
946 Free Form messages in the 835
947 MIA from Secondary Payers
949 5010X224A1 LX Repeat
950 Employer #
951 Usage of INS04=25 in 271
952 Eligibility 270 Date
955 835 5010 - QTY Loop 2100
959 278 Response Inconsistencies
960 276/277 Trace Number
963 Corrected Priority Payer Name
967 Unbundling Sales Tax
968 835 5010 TR3
974 Use of "Unknown"
975 X12 5010 271 2100C INS Use
976 Verify use of CO clm nc denied
977 1.4.7.1 # 5 PCP if applicable
978 837 Dental Modifiers
980 5010 837 Loop 2430 Repeat
981 New 835 NM1*74 5010 Rules
982 5010 837 Line Item Referral No
984 Investigational Device
985 Patient Responsibility
986 Loop 2310D + E request
987 Proprietary Location ID
988 Interest owed to payer
989 Zip Code Examples in 837P
990 270/271 5010 Section 1.4.9
991 005010x279 MSG segment usages
992 005010X279 MSG Segment Usages
997 Multiple Medical Policy URLs
998 Clarification of HIR 277
999 5 Char APR-DRG in 835
1000 SVC-06 Modifier Change
1001 278 Non-EDI Response in 5010
1005 Loop2300:HI
1006 2320 and 2400
1007 Service Location on 837P
1008 271 TR3 Possible Discrepancy
1012 Other Subscriber Info 835
1013 Claim Level Refunds in 5010
1020 270 2100B REF01=HPI post NPI
1021 REF D9
1022 Multiple use of 2120C/D NM1
1023 837P Anesth Billing requiremen
1024 Limiting R/T 276 requests
1025 271 5010 PRV02 and PRV03
1026 837I 2ary Subscriber SSN
1027 OI05 in lieu of CLM07?
1028 835 Clm Processing for CCF acc
1030 CLM07 Usage
1032 Extension/Revised Definition
1034 835 claim adj vs svc adj
1035 5010X217 278 2010F/2010FA NM1
1036 Pay-To-Plan Loop 2010AC
1042 2300 CRC03 Codes
1043 HIPPS codes in 837I
1046 Repriced Approved Revenue Code
1047 "If Not Required" Clarification
1049 Medicare Supplemental 270/271
1052 Requirement of elements
1053 837 Professional Balancing
1054 5010 DTM Claim Received Date 5010 DTM Claim Received Date
1055 MOA02 HCPC Payable Amount
1056 Multiple Denial Reasons
1057 5010_278_review
1058 835 Usage of SVC07
1059 276/277 - AMT 2200D/E Loops
1061 278 X217 Use of the 2000 UM01
1062 834 - Identification Code
1065 Tooth information for 837P
1069 270 query and search guidance
1070 837I SVD03/SVD04
1072 Section 1.4.5 - 005010X222
1074 PWK Repeat Claim & Line Level
1080 005010X212 BHT03
1081 SV206 - Accomodation revenue c
1082 835 Overpayment Compliancy
1083 response for service code 30
1088 277 Detail Status Response
1090 Definition of Episode of Care
1094 Ambulance Facility NPI Missing
1095 Patient reason for visit
1100 1.4.7.1 Item 8 and 9
1103 1.4.8 Alt Search Options
1104 Absence of ICD codes in 835
1105 837P Svc Referral Nbr Repeat
1106 5010 835-Reversal CARC usage
1107 Pay to Plan Tax Id
1108 FSAR restrictions
1109 Clarification on HIR 1060
1110 Anesthesia Claim Definition
1111 837P
1112 OHI Interpretation in 5010
1114 835 PLB Reference ID's
1115 837P COB claim balancing
1116 837I Patient Paid Amount
1120 Notes on AAA 58 & 71
1122 834 2100A/N3 Situational Rule 834 2100A/N3 Situational Rule
1123 270/271 5010 Section 1.4.7.1
1126 Other Subscriber Relationship
1128 834 QTY Segment
1130 837P, I, D CN1 Segment
1137 COB balancing on 837s
1138 Value of ISA11
1139 ST02 Tr. Control Number
1140 New Repetition Separator New Repetition Separator
1143 1.4.7.1 Individual is located
1144 NPI requirement in 834 Lp 2310
1145 278X217 Loop 2010EA NM101
1146 5010 278X217 2010EA REF
1149 EB01=D usage in 271 response
1150 Other Payer Group Information
1151 SBR01 - Payer Sequence Code
1154 278X217 2010C REF01 278X217 2010C REF01
1155 LIN segment - 837 Professional
1156 Interpretation of 2310D useage
1158 276 5010 REF*LU segment
1159 835 service/rendering provider
1167 Purpose of 'ADX' segment?
1168 Combination maps for ICD-10
1171 Use of Repricer Received Date
1174 Local Codes used by multipayer
1175 Multiple 837Is per Patient
1176 278X217 2000E CRC02
1178 PER03
1179 278X217 2000E CL104
1182 5010 837I 2320/AMT02 allow 0?
1184 2010CA REF Errata 837 50102010CA REF Errata 837 5010
1186 5010 270 271 Plan Date
1188 837I 5010 LOOP 2320 SEGMENT OI
1190 The use of "OT" Insurance Type
1192 837P - LQ02 - Form ID Code
1196 835 payer web site rule
1197 How Does a Provider Know
1200 835 Claim Overpaymnt Recovery
1202 35 5010 Healthcare Policy ID
1203 Rate-up amount on X12 834
1204 837I - Multi LIN, rev code 250
1205 835 Service Date
1208 276 005010x212 2210D/DTP
1209 SVC_01_001 equals NU with HCPCS
1210 Subpart Definition 2310C NM1
1211 277 STC Questions
1212 277 NM1 TRN Relationship
1213 Response Loop 2000E
1216 278Auth - X217 2010EB-2010EC
1217 835 Reversal and Corrections
1219 835 Splitting CPT
1220 MISSING
1221 278X217 2010C, NM106
1222 5010 278X217 Military Rank
1225 5010 278X217 HCR01
1230 ICD Proc code 835 impact
1231 Medicaid - PCP Name 271
1232 837 Dental 2000A PRV
1233 MSP SVD3-03 requirements
1234 Time of Event in 278
1235 5010 278X217 Admission Review
1238 5010 835 QTY and Reversals
1239 5010 835 Cov Expiration Date
1240 278X217 UM02 Reconsideration
1242 837I HCPCS qualifier deleted
1243 Source of 359 Treatment Codes
1244 576 Workers Compensation Codes
1253 1253 837I 2330I
1254 4010/5010 271 2100c PER Seg
1255 5010X217 278 Rqst 2000E CR607
1256 Patient's Reson for Visit
1257 Reporting unrecognized segment
1270 5010 835 2100 Rendering Prov
1272 270/271 TRN conflict
1273 GS Segment Repeat 837 vs 277CA
1274 278 PER
1275 271 when source system is down
1278 5010 837 Claim & CCN/DCN
1279 835 SVC05/07 usage for IP
1280 837I 4010 to 5010 crosswalk
1281 271 Pre-existing Condition
1283 Discharge Date ICD-10
1285 IRC3402 3% Withholding on 835
1286 5010 837P line level provider
1287 HIPAA Code Set Violation - DME
1288 2110 DTM for predeterminations
1290 CRC03 Duplicate Indicator
1291 834 ID supplemental benefit
1294 837I 5010 COB Claim Balancing
1295 270 Clarification on 2.2.1.1
1296 Clarification Not Used
1297 NDC and HCPCS conversions
1298 Split Claims for Claim Status
1299 271 TRN03 Response
1301 837 2010AA NM109 2010BB REF
1302 278X217 Service Level
1304 837D quantity and tooth number
1308 1000 A PER segment usage TX
1310 ADA Codes on the 837I
1311 999/CTX Context
1312 999/CTX - Business Unit
1313 1.4.7.1 Minimum Req 270/271
1314 5010 Errata 999 on 276 Req?
1316 INS09 usage based on INS02
1317 835 Insured Identifier
1318 834 -ICD Codes
1319 834 2100B DMG06
1320 834 Address lines
1321 834 Provider ID in 2310\NM1
1323 More than 4 modifiers
1324 Interest & PLB on 5010 835
1325 278X217 2010C N403 Postal Code
1326 Entity Identifier Codes
1327 Medicare CCN
1330 Values in the 999 GS08/ST03
1331 277CA 2200C and 2000D loops
1332 277CA 2200C STC
1333 SV103 F2 from 4010 to 5010
1334 Clarification on AMT A8
1336 CN1 for non-HIPAA use
1339 997/999 error for invalid ST
1341 HSA CAS segments
1350 835 v4010A due from patient
1352 837 - HI Segments
1353 Cordination of Benefits
1355 NS07 and INS05 dependency
1356  834 loop 2200
1360 837D 5010 Zip 4 workaround
1363 Eligibility/benefit interpret
1364 837 2010AB Usage Rule
1365 Partial Medicare Data on 834
1366 SV107 Duplicate Pointers
1367 Negative Amount
1370 Healthcare Policy ID
1371 278X217 Service Loop Count
1373 278 AAA Action Code
1374 PLB Overpayment Recovery
1377 5010 837P Loop 2310C
1379 Accept Assignment CLM 07
1382 277- Usage of STC10 and STC11
1383 CLP09 Situational Rule
1385 Returned Checks
1386 Overpayment Descrepancy
1391 2320 AMT*EAF*0.00
1392 Claim Received Date Rule
1394 POS12 and Facility Info
1397 ANSI 837P ZIP CODE LENGTH
1398 SVD05 R Type = 1.0
1399 Jurisdictional state 5010
1401 834 2300 REF
1402 005010X223A2 DTP 2300 vs 2400
1403 HCP Segment
1404 834 Country Code
1405 unbundling discrepancy
1406 278 Administrative Ref. Number
1407 835 Class of Contract REF CE
1408 277CA claim date for POB
1409 2000C/PAT01 - Qualifier Ques
1410 271: 2100C/NM103 Req'd Unless
1413 Interpretation of EQ05 in 270
1414 Rejecting non-compliant transa
1416 2320 - Other Payer Clarification
1417 2400 LOOP SV107 - 2 - 5010
1418 Multiple POB Numbers on service
1419 5010 837I 2320 AMT*D
1420 276-REF*FJ - Service Line Item
1423 835 CLP02: Claim Status Code 4
1426 Provider Contract Plan ID
1427 Fatal error ISA validation
1428 2310C FACILITY NPI 837P 5010
1429 CAS required on backed out cla
1431 Limit of INS Segment in 834
1432 HI Segment in 005010X215
1435 5010 837i DOS for TOB 12x
1436 Outlier payments and CAS seg
1437 Domestic Phone Numbee Format
1438 AK203 value in 999
1442 Part A Outpatient Service Line
1451 Restriction of PO Box Use
1453 5010 - 999 Problem
1455 835 AdjRsn 78
1477 999 CTX Context
1486 5010x223A2 - Admission Date
1488 Bad Debt/Charity pat resp 835
1489 2310B NM1 supporting role
1491 837 'un-sequenced' subloops
1492 835 Other Subscriber
1493 Code Usage TR2 Clarification
1494 837I 5010A2 2400 SV202-7
1495 005010x223A1 Loop 2300 DTP*435
1496 2010BA N3 N4 segments w/ 2000C
1497 Error Condition Codes
1498 Trailing Delimiters and 999
1499 Equivalent Values in DE 756
1500 Empty Trailing Separators
1501 balance multi 837P SVD loops
1502 Require referring provider
1503 837P CRC Hospice Employee Ind.
1505 2310C/2310D Dupe Info
1506 Service Date on 837I
1507 COB Split Claim Line in 837
1508 Multiple SVD Loops
1510 Elig Outpatient Surgical Codes
1511 TCN for mixed 837s
1512 Insurance TR3 and Rejections
1515 2320 Remaining Patient Liabili
1516 005010X212 - PreDetermination
1517 Clarification AMT*EAF
1518 MACSIS Hlth 5010 835 Takebacks
1519 Claims for both Sub and Dep
1520 837I 5010 Admission Date
1521 Remaining Pat Liability 999?
1522 837P - 2010AB Pay-to Address
1523 Validating non-medical codes
1524 5010 2300 HI DRG
1526 Section B.1.1.3.1.2 Decimal
1527 Submission of Late Charges
1528 Medicare Supp Deductable
1531 Rendering Providers in 837P
1532 2430 CAS question
1533 837 Zip Code Formats -N4
1534 HIPPS codes for HH/IRF
1535 837D COB & Hlth Plan req 2430
1536 5010 2310A usage clarification
1537 5010 2310E usage clarification
1538 5010\837I\2300\CLM05-3 and REF
1539 837I/UB Manual Relationship
1540 278 Response AAA errors
1543 003020 861 structure
1545 Accident Hour in 837I
1546 Srvc line referring provider
1547 999 application validation and
1549 837I/P 2410 LIN
1550 Patient Financial Info
1551 Unbundled Services, Balancing
1554 Product/Service ID Qualifier
1555 Line Level Balancing
1556 Medicare B Crossover 5010 835
1557 1.4.7.1 271 requirements- DTP
1558 5010 SBR09
1559 005010X221A1 1000B Payee
1560 Member's Address on 271
1562 Clarify Section 1.12.5
1563 Service Line Description & NDC
1564 Payer Sequence
1565 837 2320 CAS OA 225 Interest
1566 270/271 - OOP variations
1567 Loop 2400 SV111 005010x222a1
1569 Situational Cond. Truth Source
1570 TR3 clarification Request
1571 Billing of Anesthesia Time
1572 N3/N4 pairing
1573 5010 835 CARC 27 on Reversal
1575 Report Missing Data 277CA
1578 835 claim versus line dates
1581 BPR informational only
1582 Repeat of File Effective Date
1583 Loop 2320 AMT01=D
1584 REF- Prior Authorization 837I
1585 Reporting multi ISAs in a 999
1587 270 EQ Syntax
1588 271 - EB12 on Deductible Lines
1589 270 5010 Secondary Search Item
1591 Packaging a TA1
1592 Claim Level CAS04 = 0
1593 5010 loop 2400 DTP
1594 EB01=F (limitation) and HSD
1595 K3 Usage for Health Safety Net Claims
1596 Balancing multi benefit plans
1598 Claim Received Date
1600 HIPPS Home Health Codes
1601 837I 5010A2 2310B Oper Phys
1602 PER Technical Contact Informat
1603 TPL Avoidance
1604 Negative Balances on 835
1605 EB12=W Remaing Amount Zero
1606 2010AB NM Pay-To Name
1607 5010 2110C/REF01 ?
1608 835 inpatient line payments
1609 External Code Sources
1610 999 for Decryption Issues
1611 Situational NM104 First Name
1612 999 - Decryption issues
1613 Patient Identifier in 835
1614 Subscriber not found response
1615 Diagnosis codes in Prof 837
1618 271 2110C/D EB05 Plan Name
1619 271 member not found
1620 278 Response 2000E HCR
1621 271 -- Diagnosis Based Benefit
1623 0' in 5010/837P/SV504
1625 999 or AAA
1627 5010 837/2430 Line Splitting
1628 271 - Benefits Sub-types
1629 Revenue Codes & Modifiers
1630 STSE envelope relative to file
1631 Credit card payment in the 835
1632 835 not affected by ICD-10
1634 Use of Patient Amount Paid
1635 LookupAttempted-MID
1637 Attempt Lookup-Last Name
1638 Attempt Lookup-First Name
1639 Attempt Lookup-Date of Birth
1640 Attempt Lookup-LN and/or FN
1641 Attempt Lookup MID/MultipleHit
1642 Attempt Lookup-LN/FN Mult Hit
1643 Attempt Lookup LN/MID-Mult Hit
1644 Attempt Lookup- MID/LN/FN Mult
1645 Reporting Capitated Payments
1646 GS06 Uniqueness Requirements
1647 5010 278 2010EA loop PRV
1648 v3070 U277 bundled w 5010 835
1650 270/271 duplicate request
1651 270 same subsriber
1652 276/277 REF*1K
1653 Explicit Service Type Status
1654 Rejecting 270 in real-time
1655 ISA01 - ISA04 Usage
1656 Primary Payers' Impact
1657 Codify a tiered benefit
1661 271 TRN for dependent
1664 NDC with HCPCS or not
1665 Usage of 837I Loop 2310F NM103
1666 275 payer request
1667 271 N404 Country Code
1668 2330B REF*F8
1669 X217 2010F PER03/04
1670 HRA/HSA Payments in 835
1671 CN1 segment requirement usage
1672 Reporting NHRIC's in the 837P
1673 271 Service Type Code
1674 271 Multiple networks
1678 271 REF03 - Description
1680 277CA and 835 combined
1681 271: 2100C/NM103 With no AAA
1682 RFI # 472 - Clarity in 5010
1683 Subscriber Eligibility Loop
1684 Use of LX in REF6R of 835
1685 999 CTX01.02 type AN 1/35
1686 country code
1687 Multiple TA1's per interchange
1688 HL Segment Ordering
1689 837P Copay Coins Deduct
1690 Multiple Plan Coverage in 271
1691 271 plan max mayment exclusion
1693 5010 271 AAA priority
1694 Medi-Cal ERA
1696 Secondary payer CAS coding
1697 XV Qualifier and HPID/OEID
1699 Reporting same error twice
1700 837P SV104 and CR106
1703 271 specialist vs general prac
1704 Split Line for Partial Pmt 835
1705 5010-835 Interest Payment
1706 Locum Tenens & Orig Prov.
1708 835 TRN02 value
1710 834 full file replacement
1711 277CA Format zero dollar amt
1712 835 SVC and Case Rate pymts
1716 271, 2100C with AAA03 = 42
1717 271 2110C/D Multiplan coverage
1718 270/271 Data requirements
1719 HL segment order
1720 271 2110 Only Dental Plan
1721 Copay/Coins same service
1722 005010X216 response structure
1723 State Regs. Contradict Guide
1724 Multiple NM1 segments 835
1725 Sales Tax Submitted via Paper
1726 Reporting tax with AMT
1727 X12 271 EB Segment & Copayment
1728 834 x307, coverage specific ID
1729 Trailing Spaces
1730 Transport Location Categories
1731 N4 - Foreign Zip Code Requirem
1732 Reporting the AMT T2
1733 835 Reversals and corrections
1734 Order Finan Resp in 271
1735 ISA 15 - allowable values?
1737 Dup Remaining Seg EB03 Repetng
1738 CLP03 not org bill amount
1739 Dup Clm # with CARC 18 -835
1740 5010 K3 Usage
1741 Reprocessed Claims on an 835
1742 Service Level CLIA - 837P
1743 Member Cost Share Submission
1744 Ack of paper claim
1745 Credit Card data - 834 HIX
1746 Waivers/Demonstration Projects
1747 Comment on RFI 1555
1748 Eff/Term Dates of CARC RARC
1750 Allow Lead 0 in Value Code Amt
1751 277CA Entity codes
1752 276/277 Status for Paper Claim
1754 Usage of Loop 2330B NM103
1755 270 with 2100C EQ03 = 'FAM'
1756 Balance Forward Processing
1757 Locum Tenens 2
1758 835 claim level adjustment
1760 Balance Forward Processing - 837 PACDR CN104 Contract Code
1762 Locum Tenens 2 - Use of an EB and AAA
1763 835 PLB FB & Bad Debt/Legal
1764 835 - Alternate Benefit Paid
1765 CARC updates crosswalk
1766 835-filing ind. patient term
1767 271 & Tiered benefits
1768 820 & ACH IAT Entry Class Code
1769 820 Fed Wire/CHIPS CTP Format
1772 837I SV2 # of service lines
1773 DN104 usage in 837D
1774 270 - Multiple Request
1775 1.4.5 Change file
1776 Payer Payment Error 835 carc
1777 ERA - Use of MIA and MOA
1778 EB01 = ACTIVE or INACTIVE
1779 PCP vs Specialist Copays 271
1781 Patient Status CodeCL103
1782 ICD-10 E-Code on 837I
1783 270, INS17
1784 835-Reporting Dental Modifiers
1785 Realtime 271 Multiple 2100C
1786 2320 OI06 Note 837P
1787 conveying other Info source
1788 S codes unbundled to E,K & A
1789 835 Date of Service
1790 277-STC04 & SVC07
1791 277-STC02
1793 Loop 1000B, REF*PQ Payee ID
1794 APR-DRG & EAPG returned on 835
1796 2430 SVD03-2 clarification
1797 835 Rendering Provider
1798 Atypical Providers with an NPI
1799 Patient Cntrl Nbr for Voids
1801 835 SVC06-01
1802 CO45 Adjust as a full writeoff
1804 Request for additional info
1806 Grace Period End Date
1807 SC Medicaid 271
1808 835 and 277CA Tracking
1809 835/820 combined useage
1810 837 Inst 2420A Loop
1811 837 Multi CAS w/same Group
1812 Subscriber Pay 835 reporting
1814 Multiple SVD loops
1815 Delimiters in data fields
1817 277 Service Date
1818 Illogical Date - Responses
1819 Dental Modifier on 835
1820 Application of RFI 1503
1821 EB*R vs EB*U vs EB*W
1824 276/277 SVC03 for pend status
1825 Responsible Party Name Loop
1826 Value SBR09 for Medicare HMO
1827 Missing Loop 2310F?
1829 X12N - PER04 Segment on 27x
1832 270 Elig Resp - hyphens in SSN
1835 Recovery from other entity
1837 Discharge Hour Length
1838 834, 2100G qualifier
1839 Section 1.10.2.18 Totals withi
1840 837P Admission Date
1842 837I CLM05-1
1843 Function of REF02, EV Header
1844 834 2100B DMG Demographics
1845 Clarification NPI 2310C loop
1846 situational rule usage
1847 TRN02 Segment in 835
1849 Admit Hour for mult day OP clm
1850 837P, 2300 REF Referral number
1851 271 Explicit STC-Plan Inactive
1852 271 Rsp to 30 w/ Ntwk Variance
1854 837P, 2300 DTP*454 requirement
1855 835 paid units SVC05
1857 2300 CLM06 for 837I
1858 EMS Billing Requirement
1859 HIX Grace Period Notifications
1860 837P Prior Payer Paid Amount
1861 2310B Rendering Provider
1862 2310A Referring Provider
1863 837i REF-PAYER CLAIM CONTROL #
1864 837 I Patient Estimated Amount
1865 837 I AMT and CAS
1866 837D Quantity
1868 835 5010 ST02 AN?
1869 Appropriate return of penalty
1870 835 BPR01
1874 Nature of EFT reference number
1875 Other Payer Primary Identifier
1876 Ambulance Mileage
1877 834 DMG05-3 Repeat
1878 AMT - Per Day Limit
1879 Billing Provider Addr 2010AA
1880 Receipt of unsolicited refunds
1881 835 Void Check
1882 ICD10 in 837
1883 835: Payer Use of PER*CX Seg.
1885 5010 835 Claim Status 4
1886 837P - Report repackaged NDC
1887 Card Payments and BPR04 BOP
1889 278 2000FService Types
1890 834 Medicare Advantage
1891 837IHI Occurrence Span Info
1892 Provider contract Plan ID
1893 CARC code validation
1894 HD Loop for DMG changes?
1895 where local code in 835
1896 834 Member Level Date
1898 271 EB02 Requirement
1899 00510X220 Loop 2750
1901 271 Convey Group Funding Type
1902 Rendering Provider 2420C/2310D
1903 271 Multiple Plans for patient
1906 MKS ID 50445 - 276/277
1907 MKS ID 50453 - 276/277
1908 MKS ID 50455 - 276/277
1909 MKS ID 50569 - 276/277
1910 MKS ID 50139 - 270/271
1912 Referring Provider Drop-down
1913 1.4.8.3 Name/Date of Birth
1914 2100C/NM109 w/ Inact v Active
1915 271 multiple benefit plans
1916 medically necessary benefits
1917 Line Item Control number 835
1918 834 Req BGN01 when BGN06 exist
1919 Medicare Subrogation
1920 Modifiable Response Segmen-UMO
1921 Capitation payments 835-PCMH
1922 RxBIN and RxPCN in the 270
1924 National Drug Unit Count CTP04
1925 WC Ebills subscriber address
1926 005010X222
1927 Clarification of IK5
1930 Multiple Benefit Network Tiers
1931 INS*05 value if INS*07 present
1932 837P - Loop 2310C 5010 - Labs
1933 Payer Sequencing for COB
1934 271 2100C Subscriber Address
1935 Clarify RFI 1794 APR-DRG EAPG
1937 835 Covered Amount
1938 2300 K3 for Ambulance Data
1939 Variable FAM Deductible in 271
1940 Policy Term Dates in 820
1941 835 Predeternation with PatRes
1942 Clarification STC01-1 in 277CA
1943 XML escape characters
1944 Rev/Corr payer combined claim
1945 Replacement Claim CLP01
1948 NDC Units - 2410-CTP04
1949 THCIC TX Medicaid 2000BA/DMG05
1950 SVC /835 Required always?
1951 Ambulance Transport TR3 Note
1952 Redundancy 1.12.5
1953 Redundancy Claim vs Claim
1954 NM105 in loop 2120C
1956 Overpayment Recovery pat id
1957 EB03 in 271 for Telemedicine
1959 271 2110C/D DTP01 = 290
1960 NPI/Tax ID Mismatch Reject
1961 PLB Adjustment field lengh
1962 Loop 2300 usage (5010-837P)
1963 Medicare RUG value
1964 834 Reporting Loop
1965 Qualifier Descriptions
1968 837 PWK02 FT usage
1970 837I 2400 DTP Service Date
1972 278 HCR03 = 90 in PWK
1973 service type code 42
1975 837I, PCP group, Inpatient
1976 Overpayment Recovery
1977 837D loop 2300 REF*9F
1978 There is no direct interdependency requiring Loop 2300 Segment REF – Referral Number and Loop 2310A Segment NM1 Referring Provider if the other is present.
1980 MISSING
1981 Loop 2300 Segment, REF – Referral Number is “Required when a referral number is assigned by the payer or Utilization Management Organization (UMO) AND a referral is involved.”  Loop 2310A Segment NM1 - Referring Provider is “Required when this claim involves a referral.”
1982 MISSING
1983 From a practical business perspective a referral is made by a referring provider and thus Loop 2310A Segment NM1 - Referring Provider is required because a referral is involved.  In situations where a referral number is assigned by the payer or Utilization Management Organization (UMO) AND a referral is involved, then Loop 2300 Segment, REF – Referral Number is also required.
1984 MISSING
1985 The usage of the two segments is dictated by the situational usage rule of each segment independent of the other.  It is not correct from a TR3 usage perspective that one of the segments is required or not required by the presence or absence of the other.
1986 GS08 - ST0 Version Information
1988 999 GS01 valid values
1989 837 2310B Rendering Provider
1990 Corrected Insured Employer
1991 277CA with multiple 837 ST/SEs
1992 Balancing in 277CA
1994 Consult regarding 2310C loop u
1995 How do I read the BNF product?
1996 278 PWK02 EL Usage
1997 278 PWK02 Inclusion of the FT
1999 005010X223 AMT*A8 vs CLM*02
2000 Individual in 2010AA with EIN
2001 Duplicate Referral
2002 6020 999: IK4\CTX05
2003 Confidentiality Code on 834
2005 835 Use of PER-IC & REF-OK
2006 834 Monthly Recon Definition
2007 834: DTP segment for Medicare?
2009 Bundling svcs from > 1 claim
2010 unique trn02 per tin in 835
2012 B.1.1.3.1.2 Ambulance Mileage
2013 Corrected Priority Payer TBD
2014 Remaining Cov Benefits GiC 271
2020 US Zip Codes International
2021 INS06 COB in 834
2022 SVC03 vs CAS CO 139
2023 COB claim vs service line
2024 Multiple Functional Groups 270
2025 835/837Payer Crossover Process
2026 Delimiter in non-comp field
2027 Use of 2430 SVD
2028 SVC06 and Additional Modifiers
2029 Proper CLP02 Use
2031 782 Monetary Amount Limitation
2032 5010X222A1 CR1 loop 2300/2400
2033 278 QTY MIN/MAX
2034 How to include a TIN on an 834
2035 Line Item Control Number
2036 HSD Required When SV1 Sent
2037 834 Loop 2300 AMT & REF Repeat
2038 837I2400 SV203 Negative Amount
2039 CPT Category II and III in 837
2040 837P billing npi not in 835
2041 TRN03 for Self-Funded
2042 Service-level remarks on 837
2044 CAS OA*94 vs CAS CO*94
2045 LOINC Codes 277RFAI 005010X213
2047 Dental Vendor's 271 response
2048 CAGC CO with Coinsurance
2049 270/271 Date of Service
2050 2330B N404 Country Code Usage
2051 Forward Balance mulitiple
2052 CAS*CO*45 being used as denial
2053 Duplicate Loop 2430 SVD
2055 835 DTM
2056 EAPG in 837 I
2057 837I-Tertiary Payer & DTP_573
2059 Patient Responsibility
2060 Withdrawal/Void Claim and Resp
2061 Adjudication or Payment Date
2062 Secondary ERA adjustments
2063 BHT03 field length in claims
2064 CLP01 Replacement of #
2065 The DI of the UDI in the 835
2066 5010X223A1 - DUP 2330B
2069 Multiple REF*CE segments in 83
2070 835 EAPG representation
2071 SVC inpatient DRG add on
2072 2440 FRM05
2073 Union Covered Employees
2075 835 Relationship to payment
2076 reporting of actuals
2078 L6 in WO PLB total
2080 HIX 837 accums information
2081 EFT/ERA separate payers BPR
2083 Attachment Control # Choices
2084 COB Model Service Line
2086 AK102 Response to 837
2087 Unsolicited Finalized 277s
2091 Patient Control Number
2092 IK501 E
2093 5010 837P - 2420A & 2420D
2097 PWK02 EL usage
2098 X217-Guide PWK02 AA Qualifier
2099 999 confirming claim receipt
2101 SV311 usage in processing
2102 TA1 Response to Invalid ISA
2104 271 with Range for Plan dates
2105 STC03 and STC04 in 277CA
2107 2400 - SV205 - Service Units
2109 837P 12 DX codes 4 DX pointers
2110 ICN/DCN for xx1 Type of Bill
2111 835 BPR06-BPR11 for EFT/ERA
2112 2430*SVD05
2113 Usage of Claim Billed Amounts
2114 2430 SVD02 Negative Value
2117 Sub vs. Dependent in 270/271
2118 Negative amounts -277 STC/SVC
2119 270/271- REF- Group Number
2120 AMT02 Negative Amount
2121 Structure on 277 Response/276
2122 Multiple Interchange Envelopes
2123 835 Interest Reporting Reqquir
2125 PLB03 Levy qualifier
2126 837 Institutional SV207
2128 Times during Fall Clock change
2129 ISA & GS ID's
2130 837P prof clm admission date
2131 Incomplete PLB Transactions
2133 Acknowledgment of an 824 tran
2135 CLM05-03 usage
2136 Telemedicine use of Code E37
2137 837P-Loop2310C Serv fac
2141 Debit Card Recovery PLB03-1
2142 277 valid characters
2143 Secondary Claim Reporting -COB
2144 Spaces for Mandatory Element
2145 277CA Receiver Level Rejection
2146 837 Professional SBR09
2147 PACDR 299 Discharge Date
2148 Primary Care Provider 2310A NM
2149 OE ID
2150 CLP01 in a Reversal
2151 CPT04 Units for the 837I and 837P
2152 Clarification of RFI 1531
2153 278 AAA for unsupported UM01
2155 837/277CA NM102 = 2; NM104,5,7
2157 Contracted funding CARC 139
2160 Attachments with 278 v5010
2161 Homeless Patient Address
2162 Define CTX Business Unit 999
2163 835 - SVC05 vs 837 SVD05
2164 005010X218 820 - BPR02
2165 Line Splitting Vs Un-bundling
2166 Reporting APR-DRG on 5010 835
2167 Primary Procedure Code in Auth
2168 837 Claim Balancing
2169 UDI-DI in the 837P and 837I
2170 Invalid use of AK905 Rejection
2171 Usage of 820 Transaction
2172 EQ01/EB03 Compliant Code Use
2173 Loop 2300, REF01=F8 Control#
2174 ASN (856) Before Shipment?
2175 Extend Authorization
2176 271 MSG segment - gaps in care
2177 EB01=S Usage
2178 276/277 Claim Service Dates
2179 835 for notification only
2180 NEW MBI IDENTIFIER FROM CMS
2181 Multiple coverages same member
2183 Value Code Requirement
2184 Clarification on RFI 2123
2186 payment prior claim submission
2187 One payer MedicareMedicaid 835
2188 Useage of 5010 837P 2000B SBR
2189 Invalid Payer Sequence Order
2190 837P 2310D without 2310B
2191 Severity of Illness DRG Codes
2192 Ranges in TRN02 for 820
2193 271 ER Facility/Provider Chrgs
2194 835 Secondary Payment
2196 2310C REF LU
2197 837I SV203 zero service line
2198 Loop 2000C PAT01 Valid Values
2199 Additional Info - RFI #2189
2201 271 Repeating EB03 element
2202 PLB L6 interest
2203 277CA: non-rejecting issues
2204 CLM02 Total Claim Charge Amt
2205 Clarification on ISA02 and ISA
2206 Clarify tooth info in 837P K3
2207 Segment Delimiters
2210 Pat Resp In Unbundled Codes
2211 Duplicate TRN02 Value
2212 Language Characters in 837
2213 NY NoFault Data
2214 NY NoFault Remit Data
2215 Newborns in 278
2216 835 Order of Segments
2217 837P - 2310C Serv Facility NPI
2218 PLB Reference Number
2219 275: loop 2000A and TRN02
2220 Eligibility Benefit Renewal
2223 PLB Reference Number
2224 REF*6R FORMAT in 835's
2225 835 Out of Order Segments
2227 Use of NM1*74 on X12 835
2228 835: BPR02=0 for ACH
2229 Tertiary claim with no primary
2230 837I 2310B Operating Physician
2231 Refund with Payer Letter
2232 Medicare MBI in 834
2233 Hospital 340B Status
2234 278 Response for Non-Supported
2235 837R DMG05-03 Code Note
2236 271 III Segment Repeat
2237 271 III Exclusion
2238 Medicare Billing Identifier
2239 2110 AMT*B6 COB allowed
2240 837P tertiary claim acceptance
2241 Adjustment Reason Code OB
2243 Demonstration Project Segment
2244 ST02 in 276
2245 835 1000A REF Additional Payer
2246 P&C vs WC
2247 Next release of the X12 834
2249 Gender Codes in 834 5010a1
2250 Proper Use of 2120C Loop
2251 270 Card issue date req'd
2252 REF*EJ PCN in 277
2255 Clinical Trial Number on 837
2256 Use of 278 for PA Effectuation
2258 2320 SBR05 Requirement
2260 Anesthesia Related Procedures
2263 Patient control number REF*EJ
2264 Other language characters
2265 CPTs on the 270
2266 834: country code
2267 Multiple EB03 Segments
2268 270/271 future date handling
2269 837P Multiple Place of Service
2270 Date for Principal Procedure
2271 Returning Multiple Subscribers
2275 837D 2310B Identifiers
2276 278 admission date
2277 278 sedning 2000E
2278 Bundled zero-charge service
2280 Same Svc Addr, external NPI
2281 Subscriber/Patient address
2282 Clairifcation of MOA02 segment
2283 Service Lines 837 vs 835
2287 BPR-02 vs. Actual Deposit Amt
2288 Billing Provider for MedSub
2289 NPI value in PLB for interest
2290 Identifying FSAR covered data
2293 CTX "Business Unit ID" in 999
2295 ERSA & CN101/CN104
2299 837 negative SVD02
2300 Insurance Type Codes for Duals
2301 271 / Multiple Copay/Coinsurance
2302 Payee Tax ID and REF*TJ Useage
2303 File Type Of Acknowledgement
2304 X12 005010X221A1 - Payee REF
2307 837i Loop 2300, Segment CN1
2308 ST02 Compliance
2311 Nonbinary gender on claims
2313 271 + Health Reimbursement Accounts
2316 Place in 837 for indicator
2317 Patient in Loop 2010AA of 837P
2318 CARC 45 Questions
2319 When to use CARC 45 vs CARC 1
2320 835 SVC 06 Requirement
2321 5010 835 CLP11
2322 Imposted Constraints in ST02
2323 835 LX01 - Loop 2000
2324 811 Variance
2325 Reversal and Correction Method
2326 Suppressed Payment Agreements
2327 Member repeat on an 834
2328 276 REF*1K / 277 STC
2329 835 - ST02 Data Element Type
2330 Billing Provider contracted
2331 Patient Out of Network claim - 827
2333 0 Billed Detail Line CAS
2334 5010 - 837 P,I,D-CLM limit
2335 X214 TRN02 2200B
2337 Report APR-DRG weight in 835
2338 SV107 and Dates of Service
2339 Returning HRA amounts on 271
2342 820 5010 2000A/B Loop Usage
2343 Multiple plans & member IDs
2344 Provider Name versus NPI
2346 Table Order and Repeats
2348 835 Claim Payment Adjustments
2349 DRG vs Payment Variance
2350 Tiered CoPay
2351 Return plan premium in a 271
2352 835 TS3 by mutual agreement
2353 Can CAS03 be zero?
2354 SVC procedure Info Requirement
2355 Provider Secondary ID (837 P)
2356 Multiple TRN
2358 Clarification on 275
2359 2000A Loop AAA error
2362 835 dual coverage same plan
2363 Anesthesia Add-On HCPCS 01953
2365 CLP02 1 vs 19
2366 999 CTX
2367 Origninal Claim definition
2368 Use of K3 for SAMHSA
2369 Discrepancy in 835 Payment Ref
2370 PLB0302 usage CLP01 and CLP07
2371 835 co-insurance discrepancy
2373 Network Leasing Segment 835
2374 Originating Company Identifier
2375 Submitted vs Adjudicated Codes
2382 MBI required on HIPAA trans
2383 Loop 2200D -REF 02 Prof vs Inst
2384 831I 2300 SNF admission
2386 Use of 2420G/H for EVV
2387 AUC Mandate
2390 277-003070X070 2220D/SV03
2394 Respond to HL error
2396 Reporting TCN mismatch in 999
2398 Replacement Claims - RARC N142
2402 834 2100A/DMG/DMG06 Citizenshp
2405 824 OTI03 Note Requirement
2410 835 MS-DRG Reporting, CLP11
2412 834 ANSI Full Replacement File
2413 H-Number Assignment in 834
2415 Additional Payee Idnetifier
2416 CLM01
2423 Referring provider requirement