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Change Requests for ASC X12 Work Products

ASC X12 Change Requests

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1 LOOP 2400 Treatment Stop/Start Dates
2 LOOP 2330A Other Subscriber Secondary Identifier Repeat Count
3 LOOP 2300 Estimated Amount Due AMT Segment
4 837I - LOOP 2400/SV202-1 Qualifier Notes and associated Definition errors
5 Mammography Certification Number
6 Institutional 837 Example 3.1.1
7 Home Health Care Treatment Codes (External Code Source 359)
8 LOOP 2400 HCP08 (Product or Service ID Qualifier)
9 Inpatient and Outpatient Definitions
10 Unbundling Definition
11 1.6.4 277 Health Care Claim Acknowledgment
12 LOOP 2010CA 837 Property and Casualty Claim Number
13 Various uses of Location Number (REF01 Qualifier LU)
14 LOOP 2330B REF - OTHER PAYER CLAIM ADJUSTMENT INDICATOR
15 Loop 2010AB N3 - Pay-to Address - fix example
16 Loop 2300 REF - Investigational Device Exemption Number
17 LOOP 2300 DTP - Admission Date/Hour
18 LOOP 2300 AMT - Patient Estimated Amount Due
19 1.4.4.1 Claim Level (Balancing)
20 1.4.4.1 Claim Level (Balancing)
21 1.4.4.2 Service Line (Balancing)
22 1.5 Business Terminology (Pay to Plan)
23 1.10.2 Implementation Migration Strategy
24 1.10 National Provider Identifier Usage within the 837 Transaction
25 1.4.1.3 Coordination of Benefits Claims from Paper or Proprietary Remittance AdvicesRemittance Advices
26 1.4.5 Allowed/Approved Amount Calculation
27 1.11 Coding of Drugs in the 837 Claim
28 1.11 Coding of Drugs in the 837 Claim
29 1.12.2 Rejecting Claims Based on the Inclusion ofSituational Data
30 LOOP 2000B SBR03 Subscriber Group or Policy Number
31 LOOP 2300 DTP - REPRICER RECEIVED DATE
32 LOOP 2300 - CLAIM IDENTIFIER FORTRANSMISSION INTERMEDIARIES
33 837P - 2010AA REF - BILLING PROVIDER UPIN/LICENSE INFORMATION.
34 837P - 2300 K3 Segment vs TOO Segment
35 2400 SV101-1 (Qualifier HC)
36 2400 SV1 Yes/No Indicators
37 2000B/2000C PAT09 Yes/No Indicator
38 2400 SV107 DX Code Pointers
39 2330B Other Payer Referral Number - Change Name
40 2400 Prior Authorization Number - Change Name
41 Appendix D - Correct 2420C Repeat Reference
42 2400 PWK06 - Request for Note
43 Add TOO Segment to 837P
44 1.11 Coding of Drugs in the 837 Claim
45 P&C PER Segment - Add to all Guides
46 2000B/2320 SBR01 Request for Clarification
47 2000B SBR05 - Change to Not Used
48 Add Pre-Determination to 837P
49 LOOP 2300, REF Claim Identifier for Transmission Intermediaries
50 1.3.1 Batch and Real-time Usage
51 Inpatient and Outpatient Designation
52 Update Element Names for CLM07, CLM08 and OI03
53 1.4.5 Allowed/Approved Amount Calculation
54 Request for CUR Segment TR3 Note
55 2010AA N4 Zip Code relax 9 digit zip requirement
56 2010AA N404 - Change Situational Rule
57 2010AB NM1 Segment - Change Situational Rule
58 Patient Amount Paid
59 Add Ambulance Segments to 837 Institutional
60 Add Ambulance Segments to 837 Institutional (Duplicate)
61 2400 CR1 Information
62 2400 CR1 Information
63 Ambulance Transport
64 2400/REF04 (Referral Number)
65 2400/CRC - Hospice Employee Indicator
66 2400/DTP - Last Seen Date
67 2400/DTP - Test Date
68 2400 DTP - Last Xray Date
69 2400 PS101 - Purchased Service Provider Identifier
70 1.4.5 Allowed/Approved Amount Calculation
71 2420B/REF (Qualifier G2)
72 HI - EXTERNAL CAUSE OF INJURY
73 2010BB/REF - Correct Repeat Count
74 2400 SV103 - MJ qualifier use
75 1.10.3 Organization Health Care Provider Subpart Representation
76 Add 278 Reference to 837 P and I
77 2400 Sales Tax Amount
78 2010CA 837 P&C Number
79 2400 Sales Tax Amount vs Service Tax Amount
80 2400 Sales Tax Amount vs Facility Tax Amount
81 Add MJ qualifier to Dental 837 Unit Count
82 Correct Repeat Count for Service Facility Loop REF Segments
83 2000B SBR05 Patient Relationship Code
84 HI01-1 and SV201-1 qualifier note clarification for ABC Codes
85 2310F/2420D Repeat Counts
86 2300 Admission Date - Inconsistent usage and CL102
87 2410 LIN Segment - Unit Count
88 Prohibit ICD-9 and ICD-10 on the same claim
89 How to Report on 837 When No 835
90 Provider Definitions in Front Matter 837P
91 2400 REF - Mammo Cert - increase repeat count
92 2400 NTE - LINE NOTE
93 2300 CLM10 - unclear TR3 note
94 2400 HCP06 and HCP07
95 Factoring Agent
96 Subscriber Address Requirements for Workers' Comp. Claims
97 2300/2400 REF Inconsistent naming of Repriced Claim Numbers across TR3s
98 2300 Admission Date/Hour
99 N407 TR3 Note
100 Remove 0B Qualfiier from all Provider REF Segments
101 SV111 EPSDT Indicator
102 SV112 Family Planning Indicator
103 2400 SV115 Co-pay Exempt Code
104 5010 balancing section
105 RAS Segment
106 Other types of DRG's
107 MIA- use of Inpatient Units
108 COB 3.3 Section
109 Non-capitation Bonus
110 Advice Only: Batch 835 will need to follow with payment
111 Add Disclaimers for Property & Casualty, Workers Comp, Individual Health Plan, NCPDP
112 COB Rules in Real Time environment
113 NCPDP Statement
114 RARC Statement
115 Real Time Model--beef up information
116 Correction & Reversal Guidance
117 Predetermination
118 CDHP
119 Provider Actions--Business Usage Expectations
120 Use HC policy to report jurisdictional rules
121 Add Real Time Adjudication instructions
122 Add Secondary Payment Reporting Considerations
123 CLP01 - revise rule for consistency
124 Add Assignment Examples
125 Front Matter Updates
126 835: Proposed Date Changes
127 Revise PLB01 Verbiage
128 835: Add front matter section for further Recoupments
129 Add 835 Example
130 Revisions Related to DSMO requests
131 835: Consider EFT CCD_CTX standards
132 Add clarification: PER Payer Technical Contact Information Segment
133 Front matter Section 1.10.2.1.1 - state service level segments are required
134 Add COB Education and Examples
135 Add Consolidation Bundling Info
136 Add a Bundling Example
137 835: Using CARC codes before they are published
138 DSMO CR1053
139 Review/Revise Balancing Section
140 Add detail related to Denial Management and Retroactive PLB
141 Add Appeal Processing Section
142 Add Information to the Front-matter
143 Add 835 Subscriber-Patient Scenarios
144 Add 835 Information based on Public Comments
145 835: Middle Initial Corrections
146 Add/Revise Appeal Processing Section
147 Review/Revise Service Level AMT segments
148 Clean up Section 3.3.1.1 Examples
149 Correct Section 1.10.2.6 Partial Unbundling Example
150 Review/Revise 835
151 Review/Revise the TR3
152 REF D9 Clearinghouse Identifier
153 Sync 835 and 837 Data Elements and Requirements
154 Loop 2010AA/REF Billing Provider Tax Identification Number
155 Section 1.4.2 Property & Casualty
156 Section 1.10.4 Subparts & the 2010AA - Billing Provider Name Loop
157 Section 1.10.4 Subparts & the 2010AA - Billing Provider Name Loop
158 Section 1.12.7 Trading Partner Acknowledgments - remove
159 Section 3. Examples. Scenario 1 Information listing 6
160 Section 3. Examples. Scenario 1 Example String 10
161 Section 3. Examples. Scenario 1 Example String 20
162 Section 3. Examples - various
163 Loop 2000B - HL - Subscriber HL04
164 Loop 2010AA - NM1 Billing Provider Name TR3 Note 1
165 Loop 2010AA - NM1 Billing Provider Name TR3 Note 4
166 Loop 2010AA - NM1 Billing Provider Name TR3 Note 3
167 Loop 2010AA NM1 Billing Provider Name NM108 & NM109 & many other provider segments
168 Correct examples with 9-digit zip codes.
169 Loop 2010AB - Pay-to Address Name: Segment Names
170 Loop 2010BB Billing Provider Secondary Identification Situational Rule
171 Loop 2300 REF - Repriced Claim Number & many other segments - situational rule
172 Loop 2300 REF - Investigational Device Exemption Number situational rule
173 Loop 2300 REF - Investigational Device Exemption Number TR3 Note
174 Loop 2300 HI - Principal Diagnosis & other segments - code note for ICD-10 qualifiers
175 Many loops - Situational rule for Provider REF Segments
176 Loop 2310x & 2420x - REF - Service Facility Location Secondary Identification
177 Loop 2310x - NM1 Referring Provider Name - NM108 & NM109
178 Loop 2400 - NTE - Third Party Organization Notes
179 REF segments for Provider Secondary Identification in 2420x loops - 837I
180 REF segments for Provider Secondary Identification in 2420x loops - 837P
181 Loop 2010AA - REF- Billing Provider License Information
182 Loop 2300 - K3 - File information & Loop 2400 - K3 - File information
183 Loop 2400 - REF - Repriced Line Item Reference Number
184 Loop 2400 - REF - Adjusted Repriced Line Item Reference Number
185 Loop 2310D REF - Supervising Provider Secondary identification
186 Section 1.3.2 Other Usage Limitations - revise for real-time transactions
187 Section 1.3.2 Other Usage Limitations - revise for real-time transactions
188 Section 1.7.1 Health Care Claim Payment/Advice (835)
190 Section 1.1 Implementation Purpose and Scope - predetermination
191 Section 1.4 Business Usage - predetermination
192 Section 1.4.1 Coordination of Benefits - predetermination
193 Section 1.4.4.1 Balancing, Claim Level - predetermination
194 Section 1.4.4.2 Service Line - predetermination
195 Section 1.4.5 Allowed/Approved Amount Calculation -predetermination
196 Section 1.5 Business Terminology - predetermination
197 Section 1.7.1 Health Care Claim Payment/Advice (835) -predetermination
198 Section 2.3.1 Transaction Set Lising - Implementation -predetermination
199 Loop 2300 CLM Segment - Predetermination
200 Loop 2300 CLM Segment CLM19 - Predetermination
201 Loop 2300 DTP - Discharge Hour segment - predetermination
202 Loop 2300 DTP - Statement Dates segment -predetermination
203 Loop 2300 DTP - Admission Date/Hour - predetermination
204 Loop 2400 DTP - Service Date segment -predetermination.
205 New section in 1.12 - Date of Service for Predetermination Requests
206 Section 1.5 Business Terminology -claim definition -predetermination
207 Loop 2300 - HI - Principal Procedure Information HI01-03 & HI01-04 - predetermination
208 Loop 2300 - HI - Principal Procedure Information situational rule - predetermination
209 Loop 2300 HI - Other Procedure Information - component -03 & -04 of HI01 through HI12 - predetermination
210 Loop 2310x & 2420x - N3 - Service Facility Location Address - predetermination
211 Loop 2400 DTP - Service Date segment. TR3 Note 1 - predetermination
212 Loop 2400 - REF - Line Item Control Number - predetermination
213 Section 1.4.2 Property and Casualty - predetermination
214 Section 1.5 Business Terminology - add defintion for estimation - predetermination
215 Loop 2300 - CLM - Claim Information - CLM12 - predetermination
216 Loop 2300 - DTP-Admission Date - Predetermination
217 Loop 2300 - REF - Care Plan Oversight - sit rule - predetermination
218 Loop 2300 - REF - Care Plan Oversight - TR3 Note - Predetermination
219 Loop 2300 CRC - Homebound Indicator - Predetermination
220 Loop 2300 HI -Anesthesia Related Procedure - Predetermination
221 Loop 2310A - Referring Provider Name - TR3 note - Predetermination
222 Loop 2310B - Rendering Provider - Predetermination
223 Loop 2310C - NM1 - Service Facility Location Name TR3 Note - Predetermination
224 Loop 2310E - Ambulance Pick-Up Location & Loop 2310F - Ambulance Drop-off Location Sit Rule - Predetermination
225 Loop 2400 DTP - Service Date (837P) - Predetermination
226 Loop 2400 DTP - Prescription Date - Predetermination
227 Loop 2400 DTP - Test Date - Predetermination
228 Loop 2400 DTP - Shipped Date - Predetermination
229 Loop 2400 PS1 - Purchased Service Information- Predetermination
230 Loop 2420C - NM1 Service Facility Location Name TR3 Note
231 271: Require the Return of Financial Liability
232 271: Require the Return of Financial Liability
233 Additional Code values for HDHP/CDHP plan types
234 RASO/ASO Search Parameters
235 Tiered Benefits
236 270/271: Provider Tailored Benefits
237 External Service Type Codes
238 Service Type Codes
239 Cascading Search Logic
240 Restrictions for MSG/Disclaimers
241 Restrictions for MSG/Disclaimers
242 Penalties Apply
243 Repeating EB01
244 Additional Insurance Type Codes
245 271: Require the Return of Financial/Non-Financial Accumulators
246 270/271 Harmonization for NM108, REF01 and various HSD elements.
247 Data Dictionary & Definitions
248 Dental Specific Guidance
249 Units Quantity Qualifer
250 Clarifying What Benefit Limits and Deducibles Represent
251 Financial Limitations Apply When $ Amount Exceeds X
252 Family Deductible = X Individuals Deductibles Met
253 From-Thru/To Dates
254 Real Time Adjudication
255 Tax Deferred Health Spending Accounts
256 Add Code to HL03
257 Requirement to Respond to All EQs
258 Require the Return of Financial/Non-Financial Accumulators on 271
259 Patient Financial Liability and Applicability to Deductible/OOPMax
260 Limit Response to be Completely Dependent on Request EQs
261 Add Codes to 2110C/D REF01 in the 271
262 AAA Normalization
263 270/271 revise to support WC/PC
264 Add Additional Restrictions for Use of MSG/Disclaimers
265 Portal vs. EDI Content Requirements
266 Require Return of Termination Dates
267 Institutional / Facility Indicator Needed
268 Aggregate Patient Financial Liability Details
269 Require Past/Future Dates
270 Increase III Repeat
271 External Service Type Codes
272 Add Minimum Response Requirements
273 Add Home Health Care Codes to DTP01
274 Sub vs. Dep on 270 and AAAs
275 Add Contact Info to 2100C/D
276 Add Case Number Codes to REF01
277 Cost Containment vs. Spend Down
278 Correction to EQ Loop reference in 1.4.3
279 Correction to External Code Source Reference
280 Require the return of Financial Liability on 271
281 Correct Conflicting Situational Rules
282 Correct Conflicting Situational Rules
283 999 vs 997
284 Add Code to REF
285 Require Full Plan Name
286 Appendix Reference to 999
287 Batch Linkage Clarification
288 Require PreExisting Information be Returned
289 Require Wait Period Completion Information
290 Clean Up Situational Rules
291 Past/Future and Range of Dates
292 EB11 When Penalties Apply
293 New Qualifier Needed
294 First Dollar Coverage
295 Add Code Values to HSD
296 Enhance the PCP Requirements Enhanced
297 INS Rules
298 Absence of EBs
299 CTX05 Usage
300 Missing AK905 Codes
301 Clarify 999 Use is for Syntactical Errors
302 Revise  Paragraph 2 of the Implementation Purpose and Scope
303 Revise Figure 1.1
304 Add Examples
305 Change CTX06-2 Usage
306 CTX06 Note
307 CTX04 Note
308 IK303 Note
309 Update CTX Examples
310 Revise to Support the Medicare Rebate Program for Drugs
311 Clearinghouse/Vendor Identification Number
312 Remove References to HCFA
313 HCP13 Values T2 - T5 are not used in the industry
314 Remove HCP13 Values T2 - T5
315 Revise the MIA Implementation Name
316 Referring/Ordering Provider Definitions
317 TOO02 - Tooth Code
318 837I: HCP Segment Implementation Names
319 Change Usage of the Claim Level Repriced Approved Revenue Code (HCP08)
320 837D: Support Condition Codes for Workers' Compensation
321 837P: Support Condition Codes for Workers' Compensation
322 837R: Correct Example
323 Revise the Examples that Include UPIN
324 837P Referring Provider
325 Remove Notes Which Applied Prior to the NPI Mandate
326 Remove UPIN Qualifier
327 Remove Dual Use Language
328 Remove Dual Use Language
329 2010AA REF02 - Implementation Name
330 Remove Dual Use Language
331 Remove Dual Use Language
332 Revise 2300 DN1 Note
333 837D: Revise the DN1 Example
334 2300 DN103 Usage
335 2300 DN104 837D - Remove Notes
336 Appendix A: Update Code Source 537
337 837D: Revise the 2330D Situational Rule
338 2300/REF Prior Authorization Number
339 2330B/REF Other Payer Prior Authorization Number
340 2330/REF Other Payer Predetermination Identification Number
341 Update Section 1.10.4
342 2320/2430 CAS02 Remove Note
343 Update Section 3 Examples
344 Add REF for Dental Readiness Code
345 837P: Add New Loop for Outside Labs
346 Add New Loop for Factoring Agent
347 Expand CR8 to Include All Types of Implants
348 278: Loop 2010EA NM101
349 Add a PER to Subscriber and Dependent Loops
350 Add Code Source 886 (Decision Reason Codes) to Appendix A
351 Correct 1.3.1
352 Add Code Definitions for UM06
353 278 UM02: Clarify the Difference Between codes 4 and S
354 Add ICD10 procedure codes to CR610
355 Remove Code Source 513
356 278: 2000 UM01
357 278 UM02: Clarify the Difference Between codes 4 and S
358 Guidance on Formatting of ICD9/ICD10
359 278 - The CRC segments are being required when none of the condition codes are applicable.
360 Review the CRC Usage Note
361 Revise Patient Account Number Information in 1.12.2
362 Remove UPIN Qualifiers
363 Remove UPIN Qualifiers
364 278: Revise PER Situational Rules
365 Why is CL1 Required for Admissions
366 Update Examples
367 277CA Real Time Recommendation
368 Update Examples
369 Update Examples
370 Update Examples
371 Status Codes and Entity Codes
372 837 Section 1.7.1
373 Limit STC Segments?
374 Update the ST Segment Example
375 Add XV Qualifier
376 Review Information Receiver Status Usage
377 Review Billing Provider Status Usage
378 Add Pay to Plan Code
379 Linking Claim Status to Submitted Claims
380 Billing Provider QTY and AMT Segment Notes
381 Revise Billing Provider QTY Element Note
382 277: Add an EDI Control Number
383 277CA: Add Dental Predeterminations
384 SVC01: Add More Procedure Modifiers
385 Add Property and Casualty Claim Number
386 Add Situational Rule for Property and Casualty Claim Number
387 Add DPT Segements for Property and Casualty Use
388 TOO Segment Situational Rule
389 276/277, 277 Pending - Service Provider NM1
390 Add Notes for STC10-1 and STC11-1
391 Review the Usage Requirement for the Patient Control Number REF
392 Clearinghouse REF Situational Rules
393 PWK Segment Situational Rule
394 Review the Usage Requirement for the Line Item Control Number
395 Review the Usage Requirement for the Service Line Date of Service
396 2220D STC02 Note
397 2220D REF Segments
398 Linking Claim Status Responses Back to an Inquiry
399 Add Claim Received Date
400 276/277 - Batch vs Realtime
401 Real Time Limitations
402 Provider Information Across Levels
403 Multiple Dependents/Patients in One Request
404 1.4.3.1: STC Usage Instructions
405 1.4.2.2: Service Line Instructions
406 Add Status Response Level Guidance
407 Add Status Response Level Guidance
408 Enhance Business Terminology
409 Review DMG12 Country Code Usage
410 276/277 - Institutional Bill Type
411 Add Other Options for DMG03
412 Clarify Use of Application or Location Identifier
413 Service Line Item Identification
414 276/277 - Payer Contact Info
415 Review the Usage for Institutional Bill Type and Other REF segments
416 Payment Info at the Line Level
417 HL Segment Situational Rule
418 Establish Search Criteria
419 STC: Standardize Entity Code
422 837P: Remove references to CMN form Numbers
423 PWK02 - Standardize the Code List
424 Review 824 Feasability
425 Review 1.6.3
426 1.7.4: Update URL References
427 1.10.7: Rewrite BDS Section
428 275 x278: Review CAT03 Usage
429 Add Note to STC01-2, 10-2 and 11-2
430 Add Note to CAT03
431 Revise the OOI01 and OOI03 Notes
432 BIN and BDS Notes
433 Evaluate the 277 as a Request for the PHR 275
434 Add UPN Qualifier/ID
435 Update LOINC References
436 Update STC Notes for LOINC
437 278: Revise the 2000A/REF
438 Remove Diagnosis REF
439 Add SVC to Claims Attachment.
440 275 Additional Information: Add HI Segment
441 Evaluate Use of the HI segment in 275 HC Review
442 Add SVC to 275 HC Review
443 Remove Note Duplication - LX segment
444 837 & 278: Use Consistent Wording with that of the AMA
445 Revise HIEC Code Note
446 Revise ABC Code Note
447 Revise BDS Example
448 2110B BDS - Revise the Loop Repeat Note
449 Revise BDS Segment Note
450 Add 2110B BDS01 Element Note
451 2110B/BDS01 Code note needed
452 Add 2110B BDS02 Element Note
453 Add 2110B BDS02 Element Note
454 Revise the 2110B BDS03 Element Note
455 Delete IV in the HIEC Code Sources
456 837 and 277 Request for Additional Information: Synchronization Code Source References
457 Review Use of the SVC & HI Segments
458 Review the 1000D REF Notes
459 STC: Add LOINC Code Source Note
460 Review 824 Codes
461 Review OOI Usage
462 Add HI Segment Qualifiers
463 Add HI Segment to 2000A
464 Review Section 1.1, paragragh 3
465 Revise 1.2 of the Front Matter
466 Validate Front Matter References
467 Consistent Acknowledgement Use Across 275 guides (Section 1.75)
468 Review Section 1.10 Across the TR3s
469 Review/Revise Chapter 3
470 Revise Example Dates
471 Revise CDA References
472 Remove Unique IDs From Front Matter
473 Revise 1.6.3
474 ENT01: Increase the Length
475 834: Support Reporting of Inactive Coverage
476 Verbiage update -Clarify the Count
477 DMG06: Revise the Situational Rule
478 2100B NM103: Change to Situational
479 Standardize Situational Rules
480 Review 2000 INS10 Situational Rule
481 Hyphen Consistency: Full and Part-time
482 Spelling Consistency: Payer Or Payor
483 Word Use Consitency: Contract or Trading Partner Agreement
484 Word Use Consitency: Dependent or Dependant
485 Section 1.5 Business Terminology: Add Broker
486 2310 NM108 - Remove ID Qualifiers
487 Support Inactive Status Reporting
488 Add Involuntary Termination to INS07
489 Update Usage for ADX03 and ADX04
490 INS6-01 - Additional Codes
491 Word Use: Choose one term, Contract, Insurance Contract or Trading Partner Agreement
492 Usage 2010EB NM103
493 Consider Utilizing the MPI Segment to Identity Military Rank
494 837P: SV115 Co-pay Status Code
495 Remove Principal DX Qualifier
496 Consider Allowed Amount in the Claim Transactions
497 Revise the REF Segment Qualifiers
498 2300 Anesthesia Related Surgery HI Segment
499 Revise 2000B/2000C PAT07/PAT08 Situational Rule
500 Add Admission Date Note
501 Evaluate the Need for the Provider REF Segment
502 837R: Add HI Segment
503 837 REF: Support WC State License Number Use
504 837: CLM01 Use
505 Consider Limited Coverage Needs
506 Support the Generic Provider Role of Specialist
507 Add Bill Type Code
508 271: Enhance the Requirments for Level, Type and Amount of Information
509 Add Instructions for Forward Rolling
510 Revise Plan Date Requirements
511 Add Coinsurance Days
512 Clarify Definition for "Plan"
513 Revisions to Support Provider Needs
514 HIR Expansion
515 Add Health ID Card Reference Information
516 Add Requirement to Return All Plan information
517 Clarify Whether TPA Benefits Must Be Returned in the Response
518 Clarify Usage of the REF and EB05
519 1.4.7.1: Add Requirements for the Return of Inactive Service Type Information
520 Review Usage of Subscriber, Dependent, Patient, ETC
521 Support Additional Addresses
522 HI: Support SNOMED Diagnosis Codes
523 2000C NM106 and INS: Eliminate Reference to Benefit/Level of Care
524 1.3.2: Rewrite the Last Paragraph
525 CR6: Add Code Value "IP"
526 Code Source 235: Replace "ZZ" With "IP"
527 X275 and X278 Section 1.7.4: Revise First Paragraph
528 X278 1.7.4: Remove Bullets
529 X278: Remove Section 1.7.5
530 X278 Section 1.10.1 Figure 1.6: Update Transaction Set Listing
531 X275 1.10.1 Table 1
532 X275 1.10.1 Table 2
533 X275 Section 1.10.2: Revise First Paragraph
534 X275 1.10.2: Delete Sentences
535 X275 guide 1.10.2: ST and BGN Examples
536 X275 1.10.3: Revise First Bullet
537 X275 1.10.3: Revise Patient Definition
538 X275 1.10.3: Revise Provider Definition
539 X275 1.10.3:  Revise Provider NM1 Example
540 X275 1.10.3: Remove Extraneous Information
541 X275 1.10.4: Remove Example
542 X275 1.10.4 LX: Remove Example
543 X275 1.10.4 TRN: Remove Example
544 X275 1.10.4 TRN: Revise the First Bullet
545 X275 1.10.4 TRN: Revise the Second Bullet
546 X275 1.10.4 STC: Remove Example
547 X275 1.10.4 STC: Revise
548 X275 1.10.4 DTP: Remove
549 X275 1.10.4 CAT: Remove
550 X275 1.10.4 EFI: Remove
551 x275 1.10.4 BIN: Remove
552 X275 1.10.5: Remove
553 X275 1.10.4 LX: Revise
554 X275 BDS02 Note: Revise
555 X275 1.10.4: Add BDS Segment Information
556 X275 1.10.4: Change Title
557 X278 1.10.2: Revise the Table
558 X278 1.10.2: Revise the Table
559 X278 1.10.2: Revise the Table
560 X278 Section 1.10.2.1.1: Revise
561 X278 Section 1.10.2.1.1: Revise
562 X278 Section 1.10.2.1.1: Delete Information
563 X278 Section 1.10.2.1.2: Remove NM1 Examples
564 X278 Section 1.10.2.1.2: Remove PER Examples
565 X278 Section 1.10.2.1.2: Remove REF Examples
566 X278 1.10.2.2: Revise Figure 1.8
567 X278 1.10.2.2.1: Revise TRN Section
568 X278 1.10.2.2.1: Revise STC Section
569 X278 1.10.2.2.1 REF Section
570 X278 1.10.2.2.1: REF Section
571 X278 1.10.2.2.1: Delete DTP Section
572 X278 1.10.2.2.1: Delete CAT Section
573 X278 1.10.2.2.1: Delete EFI Section
574 x278 1.10.2.2.1:  Delete BIN Section
575 X278 1.10.2.2.1: Add BDS Information
576 X275 and X278 1.7.4: Revise first Paragraph
577 X275 ST: Revise Example
578 X278 ST: Revise Example
579 X275 BGN: Revise Example
580 X278 BGN: Revise Example
581 X278 BGN01: Revise Element Note
582 X278 1000A/NM1: Revise Note
583 X275: Add Element Note for PI Qualifier
584 X275 Section 1.1: Revise Paragraph 3
585 X275 1.3.2: Add Additional Information
586 X278 1.3.2: Revise
587 X275 1.4: Revise
588 X275 1.4: Revise
589 X278 1.4: Replace Second Paragraph
590 x278 1.4: Revise Last Paragraph
591 x275 1.4: Revise Last Paragraph
592 X275 1.4.1: Revise First Paragraph
593 X278 1.4.1: Revise First  Paragraph
594 X275 1.4.2: Revise First Paragraph
595 X278 1.4.2: Revise
596 Section 1.5 Business Terminology: Add Term
597 x278 Section 1.5 Business Terminology: LOINC references
598 x278 Section 1.5 Business Terminology: LOINC references
599 x275 Section 1.5 Business Terminology: LOINC references
600 X275 Section 1.6.3 last paragraph, second sentence
601 X278 Section 1.6.3 last paragraph, second sentence
602 X275 and X278 Section 1.7.4 - Title
603 X275 and X278 Section 1.7.4 First Paragraph
604 X275 and X278 Section 1.7.4 - Remove Bullets
605 X278 - Remove Section 1.7.5
606 x278 Section 1.10 First Sentence
607 SNOMED & 6020
608 MSG Segment Usage- Minimize by Making Changes Elsewhere
609 Add Search Options
610 Add Code for Plan Administrator
611 Claim Level vs Line Level Dates
612 Remove HIEC & ABC Codes
613 2330G Other Payer Billing Provider Situational Rule Change Needed
614 DSMO Request 1130
615 DSMO Request 1119
616 DSMO Request 1121
617 DSMO Request 1123
618 DSMO Request 1118
619 DSMO Request 1120
620 DSMO Request 1122
621 DSMO Request 1137
622 DSMO Request 1141
623 DSMO Request 1145
624 DSMO Request 1113
625 DSMO Request 1131
626 DSMO Request 1133
627 DSMO Request 1139
628 DSMO Request 1140
629 DSMO Request 1127
630 DSMO Request 1128
631 DSMO Request 1129
632 DSMO Request 1125
633 DSMO Request 1142
634 DSMO Request 1143
635 DSMO Request 1146
636 DSMO Request 1144
637 DSMO Request 1126
638 Unbundling Splits
639 Correct 1.10.2.14.1 Example 2
640 Correct 1.10.2.14.1 Example
641 NM1 Corrected Priority Payer
642 DTM - From or To Date
643 REF Service Identifier
644 Add Front Matter Section: RARC codes and Retroactive Claim Adjustments
645 Add Claim Identification Number for Clearinghousee and Other Transmission Intermediaries
646 Add PLB Adjustment Reason Codes
647 Add Payer Web Site
648 2100 REF: Add 9V Qualifier
649 Add Clarifying Language: Clean Claim Date vs Claim Received Date
650 Consistency Between 2100 Other Claim Related Identification and the Service Identification REF Segments
651 REF*CE (with inclusion of REF04) – AMA DMSO contracting entity.
652 PER*AF (or ZZ) – AMA DSMO funding entity.
653 REF*ATF (2100 and 2110 loops) – AMA DMSO fee schedule identifier.
654 Enhance information on line splitting
655 HIR 1000
656 Add payer Web site PER 2U / add an example
657 Coordiated work with X12F on items in table 1 - slight changes will be needed.
658 REF 5N adding for state citations/ add an example
659 Add Property & Casualty Claim Number Reference Identification X12 REF01“Y4” to Loop 2100; REF Segment
660 Add Date/Time Qualifier Code 431: Onset of Current Symptoms or Illness date
661 Add Date/Time Qualifier Code 439:Accident Date
662 Business and structural - compliance front matter
663 Remove TS2 segment – Deb was to follow-up with WEDI – this needs to be documented and done in 6020
664 Remove use of CARC 42 in all examples
665 Front matter sectiion: Bonus payments in the 83 not related to Capitaion.
666 Reasons for claim splitting – Needs reviewed for 6020
667 Front matter - added detail on Bundling and COB.  Use of CARC 97 integrated in the process. – needs reviewed for 6020
668 #20 - Front Matter section:  PIP vs CAP payment. This needs reviewed for 6020
669 TS3 note - remove reference to Medicare
670 Add indicator for 'type of claim'
671 835 - Add language in front matter section from the Federal Register stating "… 835 required at provider discretion…"
672 Create an attachment component to be able to send image or link to image within the 835.
673 835 - Add 'Mode of Delivery': paper vs electronic clearinghouse vs direct delivery
674 835 - Add crossover N1 segment with multiple occurrances
675 Need to define CLP15 and usage
676 835 - Bank to Bank Transfer - review need for a new 1000C loop
677 Repricer - Providers need to know if reprocer was used
678 835 - Make Claim Adjustment Group Code an external list
679 835 - Reorganize all front matter sections
680 835 - CLP02 - add codes to indicate reversal of secondary and tertiary claims
681 Eliminate the REF Version ID segment
682 The Bundling section discussing adjusting off non-paying service lines
683 Consider adding NTE or K3 segment
684 1000B N3 segment (Payee Address) (page 104 & 105).
685 Review notes on SVC and relax edits codeset usage for invalid submitted codes
686 Send back the original Claim Status Code in CLP02
687 Please consider using the rules of the CLP04 in the CLP05.
688 CR 36-Home Health Agency
689 Refund possible changes to this front matter
692 DSMO Request 1147
693 2010AC (PID), 2010BB and 2330B NM108 Data Element Note for National Plan ID (PIDR)
694 2010AC (PID), 2010BB and 2330B REF Segment Situational Rule for National Plan ID (PIDR)
695 2000B and 2320 SBR09 Data Element Note for National Plan ID all guides
696 2010AC (PID), 2010BB REF01 2U Qualifier Note for National Plan ID (PIDR)
697 2330B REF01 2U Qualifier Note
698 999 - ISA13 error reporting need
699 Add new Situational Rule for Loop ID 2330 (Other Payer Billing Provider Secondary Identification) all 837 guides
700 Modify Situational Rule for Patient's Reason for Visit (Loop 2300 HI Segment)
701 DSMO Request #1148
702 New Glossary Definitions
703 Define patient vs insured vs subscriber vs dependent
704 Remove ICD9 Examples from Diagnosis and ICD Procedure Codes
705 835 Operating Rules
706 824 - Add batch and item details to 824, OTI03 data element
707 HIR 215 Examples to be added
708 HIR 367 Code value 901 (if available yet) added to AAA03
709 HIR 395 Add clarifications re: usage of last name and suffixes
710 HIR 447 AAA03=80, usage limitation re: Clearinghouses/VANS
711 HIR 542 271 EB & AAA Response
712 HIR 550 Sending Primary/Secondary Policies
713 HIR 845 Repeating EB03
714 HIR 895 Use of MSG or code list values
715 HIR 898 Use of repeating data element & subsequent segment/element details
716 HIR 1025 271 5010 PRV02 and PRV03
717 HIR Alternate Search Options
718 NCPDP Operating Rules & 270/271
719 Patient's Reason for Visit (HI Segment) 837I (HIR 1256)
720 New Search Option (excluding Member ID)
721 Home Health Agency
722 New Codes and or New Data Elements Needed to Minimize Use of the MSG Segment in the 271 Transaction
723 HIR 309 Requested date on a response
724 HIR 881 STCs do not apply to OOP maximum
725 Rendering Provider Loops in Prof/Dent
726 HIR 1137 Add Clarification to Section 1.4.4.1
727 824 transaction reference update
728 835 Timing
729 BHT04 (Transaction Creation Date)
730 Payer Claim Control Number
731 Update Section 1.4.4.1 Claim Level Balancing
732 2310D/2420D Supervising Provider Clarification of Use (HIR 1286)
733 Consistent Segment Representation across guides
734 Loop 2300 HI - Occurrence Span Information (Predeterminations)
735 Loop 2300 HI - Occurrence Information (Predeterminations)
736 Modify NM1 X12 Set Notes to include other entity types
737 Add Repricer Capability to the 277CA
738 PWK10/PWK11 Add rules around LOINC codes. Also evaluate PWK01 code values to coincide with LOINC
739 999 - RFI 1260 TA105 code “032” for ISA11
740 999 - RFI 1261 TA101 invalid if ISA13 invalid
741 999 - RFI 1262 999 with an invalid AK101
742 999 - RFI 1263 GS08 can create invalid 999
743 999 - RFI 1264 Invalid GS08, needs 999 code
744 999 - RFI 1266 999 with an invalid AK102
745 999 - RFI 1267 999 with an invalid AK202
746 999 - RFI 1268 999 with an invalid AK201
747 999 - RFI 1269 999 with an invalid AK203
748 Define Requirements around III Segment or Remove from 6020
749 Advanced Billing Concept Codes (ABC) RFI 901/902
750 Add Plan Participation Code in Loop 2320 (OI05)
751 Update Assistant Surgeon example for 837D Loops 2330H and remove 2 value from NM102
752 RFI 1353 Total Non-covered Amount
753 Request DM to add data element 1359 to the OI Segment
754 Modify Shared Note 1541 for use of ICD-10 Code Set for diagnosis code segments
755 DSMO Request 1158
756 DSMO Request 1160
757 Change Pay to Plan NM101 value from PE to PTP
758 Change Situational Rules for Loops 2300 and 2400, Data Elements CR101 and CR102
759 Change Situational Rule for 2300/2400 CR109 from Note 871 to Note 4448
760 Remove the restrictive requirement of a 9 digit ZIP code in N403
762 Update Present on Admission Indicator based on DE change from 1073 to 1271
763 DSMO Request 1161
764 Revisit all provide REF segments to ensure (where appropriate) we eliminate the possibility of receiving an empty NM1 Segment on claims
785 X259 Loop 2300/CN1 Change all Element Situational Rules and add TR3 Note
786 X290 Section 1.3 conflicting sentence
787 X290 Section 1.4 Awkwardly worded paragraph
788 X290 Section 1.4 Incorrect document title for ARM
789 X290 Section 1.6 Purpose of Acknowledgement clarification
790 X290 Section 1.5: Clarify Reference
791 X290 Section 1.9 Reference to X12.6
792 X290 Section 1.9 Incorrect document title for ARM
793 X290 Section 1.9 Insert IGCC
794 X290 Section 1.9.1.1 Diagram Missing Line
795 X290 IK3 CTX Business Unit Identifier TR3 note and CTX01-01 the same
796 X290 IK3 CTX Business Unit Identifier CTX01-02 when longer than 35 pos
797 X290 IK4 IK402 Situational rule
798 X290 AK2 IK4 Inconsistent loop value
799 999 - X290 Section 3.1 Typo in second sentence
800 999 - X290 IK4 IK4 TR3 example
801 999 - X290 IK303 loop identifier too short
802 999 - X290 IK303 Request for Change: 999 IK3-03
803 X260 & X262 Loop 2300 CL1 Correct Segment Example
804 X259 Loop 2300/2400 CR106 Add Data Element Note for decimal clarification
805 X259 Loop 2300 CRC Ambulance Certification Situational Rule Change
806 X259 Loop 2300 CRC Homebound Indicator Add N code value to Code LIst
807 X261 Loop 2300 DN1 Change Segment Name to coincide with Implementation Name
808 X259 & X261 Loop 2300 Accident Date and X259 Onset of Current Symptom or Illness Date Situational Rule Change
809 X259 Loop 2300 Admission Date Situational Rule Change
810 X260 & X262 Loop 2300 Admission Date/Hour Multiple Changes Needed
811 All 837 Claim Guides Loop 2300 Shared TR3 Note Change - Multiple Segments
812 X261 Loop 2300 Applicance Placement Date Segment Name Change
813 X259 & X261 Loop 2300 Accident Date Grammatical Correctiont to Situational Rule
814 X259 Loop 2300 Discharge Date Situational Rule Change
815 X259 Loop 2300/2400 Prescription Date - Situaitonal Rule Change and TR3 Note Removed
816 All 837 Claim Guides Loop 2300 HCP06and HCP07 - Change to Not Used
817 X259 Loop 2300 HCP03 - Change Industry Name
818 X259 Loop 2300/2400 HCP Segment - Remove TR3 Note 2
819 X259 Loop 2300 HCP Claim Pricing/Repricing Information - HCP01 Remove code value 06 Per Diem Pricing
820 X259 Loop 2300 HI Health Care Diagnosis Code - HI07-01 Remove BF Code Value
821 X262 Loop 2300 HI Principal Procedure Information - Remove TR3 Note
822 X260 Loop 2300 Principal Procedure Information - HI01-01 Typographical error in CAH code note
823 X259 Loop 2300/2400 K3 File Information - Correct format of Situational Rule and Industry Name
824 X259 Loop 2300 Claim Information - CLM08 Clarify Code Note for N code value
825 X259 and X261 Loop 2300 CLM Claim Information - CLM11-04 Grammatical correction
826 X259 Loop 2300 CLM08 - Code Note for W code value
827 All 837 Claim Guides Loop 2300 CLM Segment - Change "Dependent" Reference to "Patient"
828 X259 Loop 2300 & 2400 Prescription Date - Change Situational Rule
829 X261 Loop 2300 NTE Claim Note - Change Example to be Dental Specific
830 All 837 Claim Guides Loop 2300 PWK - Remove the word "Amount" from the Segment Name
831 X259 Loop 2300 REF Care Plan Oversight - Change Example to contain an NPI
832 All 837 Claim Guides Loop 2300 REF Claim Identifier for Transmission Intermediaries
833 X261 Loop 2300 REF Dental Readiness Classification Code - Change grammatical error in Situational Rule
834 X259 & X260 Loop 2300 REF Prior Authorization - Clarify TR3 Note
835 All 837 Claim Guides Loop 2300 REF Prior Authorization - Change Situational Rule
836 All 837 Claim Guides Loop 2300 REF Referral Number - Situational Rule Change
837 All 837 Claim Guides Loop 2320 AMT Patient Remaining Liability - Change TR3 Note
838 All 837 Claim Guides Loop 2320 AMT Patient Remaining Liability - Change Situational Rule
839 All 837 Claim Guides Loop 2320 MOA Outpatient Adjudication Information - Change Situational Rule and add new TR3 Note
840 All 837 Claim Guides Loop 2320 OI Other Insurance Coverage Information - Change OI04 and OI06 to Not Used
841 X259 Loop 2400 CR1 Ambulance Transportation Information - Change Situational Rule for CR101 and CR102
842 X259 Loop 2400 CR1 Ambulance Transportation Information - Change Segment Situational Rule
843 X259 Loop 2400 CR3 Durable Medical Equipment Information - Change Situational Rule
844 X259 Loop 2400 CRC Condition Indicator/Durable Medical Equipment - Change Situational Rule
845 X259 Loop 2400 Begin Therapy Date - Change Situational Rule
846 X259 Loop 2400 Last Certification Date - Change Situational Rule
847 X259 Loop 2400 Certification Revision/Recertification Date
848 X259 Loop 2400 Last Seen Date - DTP03 Industy Name Change
849 X259 Loop 2400 Prescription Date - Change TR3 Note
850 X259 Loop 2400 Service Date - Correct Situational Rule Formatting
851 X260 Loop 2400 Service Line Date - Multiple Changes
852 X259 Loop 2400 MEA Test Result - Change Situational Rule
853 X259 Loop 2400 PWK Durable Medical Equipment Certficate of Medical Necessity - Change Situational Rule
854 X259 Loop 2400 QTY Ambulance Count - Remove TR3 Note
855 X259 Loop 2400 REF Adjusted Repriced Line Item Reference Number - Change Situational Rule
856 x259 Loop 2400 REFs for Prior Authorization and Referral Number - Change Segment Repeat Count
857 All 837 Claim Guides Loop 2400/2420 - REF04-02 Element Note Change in Multiple Locations
858 X259 Loop 2400 Prior Authorizatoin Number - Add TR3 Note
859 X259 Loop 2400 SV1 Professional Service - SV101-07 Situational Rule Change
860 X259 Loop 2400 SV1 Professional Service - SV121 (Modified Charge Indicator) Usage Change
861 X260 Loop 2400 Institutional Service Line - SV202-07 Situational Rule Change
862 X260 Loop 2400 SV2 Institutional Service Line - Situational Rule Change
863 X261 Loop 2400 SV3 Dental Service - Change Segment Example
864 X261 Loop 2400 TOO Tooth Information - Change TR3 Note
865 X261 Loop 2400 TOO Tooth Information - Situational Rule Change
866 X259 Loop 2400 SV1 Professional Service - SV102 Element Note Change
867 All 837 Claim Guides Loop 2430 SVD Line Adjudication Information - SVD03-03 Situational Rule Change
868 X259 Loop 2430 Line Adjudication Information - TR3 Note Change
869 All 837 Guides Multiple Loops PER Contact Information - Change TR3 Note
870 X262 Loop 2000B SBR Subscriber Information - Add TR3 Example for Source of Payment Typology
871 All 837 Claim Guides Loop 2010AB N3 Pay-to Address - Add Street Address Example
872 All 837 Guides Loop 2000C HL Patient Level - Change Code Note for Code Value 23 (Dependent)
873 X259 Loop 2010AA Billing Provider Name and Billing Provider Tax Identification - Change to TR3 Notes referencing Tax ID
874 All 837 Claim Guides Loop 2010AA N3 Billing Provider Address - Add TR3 Note
875 All 837 Claim Guides Loop 2010AA PER Billing Provider Contact Information - Change Situational Rule
876 X261 Loop 2010AA PRV Billing Provider Specialty Information - Change TR3 Example
877 All 837 Guides Multiple Loops, Multiple Provider Secondary Identification Numbers - Change A6 Code Note
878 All 837 Claim Guides Loop 2010AC Pay-to Plan Name - Remove TR3 Note
879 All 837 Guides Loop 2000BA Subscriber Name - Add TR3 Notes
880 All 837 Claim Guides Loop 2010BA/2330A Subscriber Name - Change NM108 Code Note
881 All 837 Claim Guides Loop 2010BA Property & Casualty Claim Number - Add TR3 Note
882 X262 Loop 2010CA REF Property & Casualty Patient Identifier - Change Segment Name
883 X261 Loop 2310A Referring Provider Name - Remove TR3 Note 2
884 X259 and X261 Loop 2310A REF Referring Provider Secondary Identification - Remove DN/P3 Code Notes
885 X261 Loop 2310A Referring Provider Name - Add TR2 Note
886 X261 Loop 2310A Referring Provider Secondary Identification - Remove TR3 Note
887 X259 and X262 Loop 2310 Multiple Provider Name - Change TR3 Note
888 All 837 Claim Guides Loop 2310 Service Facility Location Name - Change NM103 to Situational
889 All 837 Claim Guides Loop 2310/2420 Service Facility Location - Change Segment Names to "Service Location" NM1, N3, N4, REF, associated Implementation Names and Rules/Notes that mention this provider type
890 X259 Loop 2310C Service Facility Location Name - Change Situational Rule to address NPI
891 X259 & X261 Loops 2310/2420 REF Service Facility Location Secondary Identification - Change Situational Rule
892 X260 Loop 2310D Rendering Provider Name - Change Situational Rule
893 X259 Loop 2310E Ambulance Pick-up Location - Change Situational Rule
894 X259 Loop 2330A NM1 Other Subscriber Name - Change NM108 "MI" Code Note
895 All 837 Claim Guides Loop 2330A NM1 Other Subscriber Secondary Identification - Change Segment Name and Implementation Name
896 All 837 Claim Guides Loop 2330B/2430 DTP Claim Check or Remittance Date - Change Implementation Name
897 All 837 Claim Guides Loop 2330B REF Other Payer Claim Control Number - Change F8 Code Note
898 X259 & X260 Loop 2330B REF Other Payer Prior Authorization Number - Add TR3 Note
899 All 837 Claim Guides Loop 2330B REF Other Payer Secondary Identifier - Remove REF02 Element Note
900 All 837 Claim Guides Loop 2330B Other Payer Claim Control Number - Change Situational Rule
901 X259 & X261 Loop 2330C NM1 Other Payer Referring Provider - Remove NM1010 DN/P3 Code Notes
902 X259 Loops 2330C Other Payer Referring Provider Secondary Identification and 2330E Other Payer Service Facility Location Secondary Identification - Remove TR3 Note
903 X262 Loop 2420A NM1 Operating Physician Name - Correct TR3 Example
904 All 837 Claim Guides Multiple 2420 Provider Loops - Add Note to A6 Code Value
905 All 837 Guides Multiple Loops for Provider Secondary Identification - Correct Typographical Error
906 X261 Loop 2420B REF Assistant Surgeon Secondary Identification - Change TR3 Note
907 X259 Loop 2420E NM1 Ordering Provider Name - Remove NM101 Element Note
908 X259 Loop 2420E N3, N4, PER Ordering Provider Loop - Change Situational Rules to use DME instead of DMERC
909 X259 Loop 2420F NM1 Referring Provider Name - Remove DN/P3 Code Notes and add TR3 Note
910 X259 Front Matter Section 1.10 National Provider Identifier Usage within the HIPAA 837 Transaction - Change Section 1.10.2
911 X259 & X260 Front Matter Section 1.11 Coding of Drugs in teh 837 Claim
912 All 837 Guides Front Matter Section 1.12 Additional Instructions and Considerations - Remove Section 1.12.5 Claim and Line Redundent Information
913 X259 Front Matter Section 1.4 Business Usage - Clarify 1.4.2.2 Coordination of Benefits Form Paper or Proprietary Remittance Advice
914 X259 Front Matter Section 1.4 Business Usage - Correct Examples in Section 1.4.2.3 Bundling with COB more than 2 Payers
915 X259 Front Matter Section 1.4 - Section 1.4.2.3 COB Service Line Procedure Code Bundling and Unbundling, Update CARC descriptions
916 X260 Front Matter Section 1.4 Business Usage - Section 1.4.5.1 Claim Level Balancing
917 X259 Front Matter Section 1.4 Business Usage - Change last sentence of 1.4.5.1 Claim Level Balancing
918 X259 Front Matter Section 1.4 Business Usage - Section 1.4.3 typographical error
919 All 837 Claim Guides Front Matter Section 1.4 Business Usage - Replace Section 1.4.3 Property and Casualty
920 All 837 Claim Guides Front Matter Section 1.4 Business Usage - Change last bullet of Section 1.4.4.2.2.4 Hierarchical Level (HL) Structural Summary
921 All 837 Claim Guides Front Matter Section 1.4 Business Usage - Update 2nd Paragraph under 2) in Section 1.4.5.1
922 X259 & X261 Front Matter Section 1.4 Business Usage - Update Deductible reference in Section 1.4.2.3 Coordination of Benefits - Service Line Procedure Code Bundling and Unbundling
923 All 837 Claim Guides Front Matter Section 1.4 Business Usage - Remove Bullet under 1.4.2.3 Coordination of Benefits - Service Line Procedure Code (Bundling:)
924 X259 and X261 Front Matter Section 1.4 Business Usage - Update RAS information in Unbundling Example in Section 1.4.2.3
925 837 Section 1.5 Business Terminology: Encounter Definition
926 X261 Front Matter Section 1.5 Business Terminology: Secondary Payer Definition
927 X262 Appendix A - Remove Code Source 513 (HIEC Codes)
928 X259 Section 3 Examples - Correct DTP02 to "D8" in Example3.1
929 X259 Section 3 Examples - Correct DTP02 to "D8" in Example3.1
930 X262 Section 3 Examples - Correct Typographical errors
931 All 837 Claim Guides Table 1 BHT Beginning of Hierarchical Transaction - Change Code Note for Code Value 31
932 X262 Table 1 BHT Beginning of Hierarchical Transaction -
933 837 Institutional & Reporting Guide - Correct Terminology for BBQ and BBR Qualifier for DE 1270
934 824 X257 Section 1 incorrect reference to ARM
935 824 X257 Section 1.4 incorrect reference to ARM
936 824 X257 Section 1.10 Update content to refer to X12.6
937 WPC tesitng workgflow
938 checking channels are open
939 Troubleshoot email
940 837 Professional and Dental Guides - Find a permanent home for Service Authorization Exception Code at the claim level
941 All 837 Guides add ME (Medicare Advantage Plan) code value to Loop 2000B and 2320 SBR09
942 All 837 Guides add new code value to Loop 2000B and 2320 SBR09 for "Unknown"
943 All 837 Claim Guides - Add RAS Example to show multiple remark codes
944 All 837 Claim Guides - Change Code Source 530 Description (DE 1270)
945 All 837 Claim Guides - Change Code Source 582 Description (DE 1270)
946 All 837 Claim Guides - Change section 1.12.2 Rejecting Claims Based on the Inclusion of Situational Data
947 All 3 278s PER segments will allow a contact name and contact communication number to be sent.
948 837P & 837D Sections 1.4 and 1.5: Add Factoring Agent and Predetermination
949 All 278s 2010F/NM101 Need ability to capture the Admitting provider role at the Service Level
950 Common Content Section 2.2.1.1 Transaction Compliance Related to Industry Usage - TR3 Compliance with Situational Rules
951 837 Professional Guide - CRC01 (DE 1136) Change code value from ZZ to EP
952 837I - Change Qualifier for All Other Operating Physician Loops
953 X266 Loop 2000E/CR6 Update TR3 Note for ICD-10
954 Add the CR8 segment to All 278s.
955 All 278s 2010 EB N404 Modify the Patient Event Transport Information to allow for International Addresses
956 278 - 2010EC/N401/402/N403 Modify the situational rules so that they are consistent to return the address information.
957 All 278s 2010 EA/PRV01 Add ‘H’ for Hospital to the value list
958 All 278s 2000E/HI Clarify the intention and use of the HI segment used to capture the diagnosis
959 All 278s 2000F/SV1/SV2 Clarification of how to capture drug requests within the 278 by adding a TR3 note
960 All 278s 2010 EB/N3 Flexibility needed for N3 to describe an address when there is no actual street address available
961 All 278s 2000C/NM108 Evaluate the code note for MI for the Member Identification Number and mirror claims if applicable
962 All 278s 2000C NM1, Section 1.4, Chapter 3 Update 278 guides to support Workman's Compensation Utilization Management requests
963 278 Evaluate NM101 and PRV01 values for all guides
964 278 - X266 1.4.1 Heath Care Transaction Flow Wording Change
965 278 - Provider NM106 Situational Rule Validation
966 278 - X266 2000E/CR6 Change to TR3 Note
967 278 - X266 2000E CRC 1321 Condition Code/Indicator Value List
968 278 - X265/X266 Section 3 Examples
969 All 278 2000C Modification to Support Workers Compensation
970 All 278 2000EA/F NM101 Code Set Modification
971 278 - X266 2000E/HSD05 Word Change
972 278 Request/Response Chapter 3.6.2, Modify the dates in the example for 2000F for a Medical Service Reservation
973 278 Request/Response Chapter 3.6.1, Modify the dates in the example for 2000F for a Medical Service Reservation
974 278 - 2000F DRA TR3 Example Not Present in all 278 guides
975 278 - X266 2000E CR6 Example Needs Update
976 278 - X266 3.5.1 Request for Non-Emergency Transportation 2000C HL Example
977 278 - X266 3.5.1 Request for Non-Emergency Transportation 2000E DTP Example
978 278 - X266 3.5.2 Response to Non-Emergency Transportation Table 1 BHT Example
979 278 - X266 3.5.2 Response to Non-Emergency Transportation 2000C HL Example
980 278 - X266 3.5.2 Response to Non-Emergency Transportation 2000E DTP Example
981 278 - X266 3.6.1 Request for Medical Services Reservation Table 1 BHT Example
982 278 - X266 3.6.1 Request for Medical Services Reservation 2000C HL Example
983 6020x275 Errata - Add. REF segments to synch with 277 x268
984 275 Claim Attachment - Electronic Submission of Medical Documentation (esMD)
985 Typographical errors
986 824 X257 Section 1.1 paragraph 5, first sentence change
987 824 X257 Section 1.1 paragraph 5, next to last sentence, delete 997
988 824 X257 Section 1.4 paragraph 1, first sentence, delete '997 or'
989 824 X257 Section 1.10.1.1 remove the 'X12 Standard Conformance' column of the diagram.
990 824 X257 Section 1.10.1.1 paragraph 2, note indicator 1 and note.
991 824 X257, OTI03 Removing development related note
992 837 Professional Guide - Removal of the 2400 - CRC - Hospice Employee Indicator
993 837 All Claim Guides - Change Loop 2330A/N4 Other Subscriber, City, State, ZIP Code Situational Rule
994 All 837 Claim Guides - Other Payer Claim Adjustment Indicator
995 837 Professional Guide - Correct Loop 2300/CN1 Situational Rule and all CN1 Element Situational Rules
996 837 Professional and Dental Guides - Change Situational Rule Sub-element references for CLM11 in Accident Date Segment
997 837 Professional Claim - Increase Diagnosis Code Repeat to more than 12
998 All 837 Transactions Allow Redundant Data at the Claim and Service Line Levels
999 ST02 Notes Consolidation
1000 837 Institutional and Professional Guides - Add BHT01 Note
1001 835 Other Claim Related Idenfication Number Social Security Value
1002 All transactions with N404 (Country Code) - Modify situational rule to accommodate US territories
1003 837 Institutional Guide - Change Loop 2300 HCP06 and HCP07 from Not Used to Situational
1004 837 Professional and Dental Guides - Add Loop 2300 TR3 Note for claim versus line override
1005 AMT Purchased Service Amount - inconsistent in prof, doesn't match inst or dental
1006 835 Claim Payment - Request to add Inpatient Indicator
1007 835 Claim Payment - MIA and MOA Claim Payment Remark Codes
1008 All 837 Claim Guides - Remove Note: under Section 1.4.4.2.2 Table 2 - Detail Information
1009 All 837 Guides - Change last sentence of first paragraph under Section 1.4.4.1 Loop Labeling, Sequence, and Use (837D/I/P) and Section 1.4.2.1 in (837R)
1011 Section B.1.3.2 and B.1.1.4 are not consistent.
1012 Resolve Discrepancy in Common Content sections B.1.1.3 and B.1.1.4
1013 Dollar Amount Elements
1014 Correct section 1.4.2.1.6 of the X306 820 HIX guide
1015 All guides - Add capability to report HPID and modify any additional verbiage associated with HPID.
1016 All guides - Add capability to report OEID (for non-atypical health plans) and add any verbiage associated with OEID.
1017 All guides - Add capability to report OEID (for atypical providers) and add any verbiage associated with OEID.
1018 837 Institutional and Professional Guides - Correct Service Predetermination Segment Repeat and REF04-02 Industry Name
1019 Provider Assigned Claim Number REF - change qualifier and notes
1020 DSMO 1178 - All 837 Claim and PACDR guides - add code value FR to CN101
1021 X268 Front Matter Section 1.4 / Remove 997 reference from figures 1.1 & 1.2
1022 275 Additional Information to Support a Healthcare Services Review - Add Loop 1000C REF for Property & Casualty Claim Number
1023 278 Notification Loop 2010E- add code value 45 to AAA03
1024 278 Request/Response - Modify Section 1.12.5.2 with text and examples to allow a Payer to return an attachment with the response.
1025 278 Notification Loop 2010EC - Allow the Patient Event Transport Information loop to be returned in the response
1026 275 6020 Additional Info to Support Healthcare Claim or Encounter - addition of REF - Property & Casualty Claim Number
1027 275 - Additonal Information TR3's - HI composites need ending instruction
1028 837 Claim Guides - Add Implementation Name to Loop ID 2320 OI05 (Provider Agreement Code)
1029 Member information for state reporting purposes
1030 837 Professional Claim - Change Situational Rule Loop 2410 LIN Segment
1031 Membership Information for State Reporting
1032 835 - Source of Payment Typology Code.
1033 CARC/RARC TR2 - Update Jan 2012
1034 835 Claim Payment - Revision to the Overpayment Recovery front matter
1035 835 Claim Payment - CLP02 value when the payer is NOT primary
1036 835 Claim Payment - MIA use of Inpatient units element
1037 Incorporate Real Time Instructions
1038 835 Claim Payment - CDHP, HRAs, HSAs in the 835 transaction
1039 835 Claim Payment - PLB segment changes for adjustment reason codes
1040 835 Claim Payment - Add TOO segment to the 835 transaction
1041 835 Claim Payment - Update old CARC/RARC and Dates in Examples
1042 835 Claim Payment - Add indicator for type of claim (institutional, professional, dental) submitted.
1043 835 Claim Payment - Add more iterations of the NM1 segments in the 835 loop 2100
1044 835 Claim Payment - CLP02 new qualifiers for reversal and secondary claim, reversal and tertiary claim.
1045 835 Claim Payment - Remove the REF Version ID segment from Header loop
1046 835 Claim Payment - Include additional qualifiers in the AMT segment for other types of tax
1047 835 Claim Payment - CLP11 composite element
1048 835 Claim Payment - QTY balancing - include implicit directions
1049 837 Claim Payment - Reversal claims - list of all elements that are included in reversal claim
1050 837 PACDR Guides - Correct Loop 2330C NM1 and REF Implementation Names
1051 Create new TR3 for Electronic Service Information Discovery
1052 X12 Transaction Tracking Audit ID
1053 837 Institutional and Professional Guides Loop 2410/CTP04 – Change Implementation Name
1054 270 - Correction of Error, 2100 AAA03 of 'OV'
1055 835 Claim Payment - Update BPR to support $0 payments with EFT transactions
1056 835 Claim Payment - Clarify usage of BPR03=D / Debit Transactions
1057 835 Claim Payment - Add Mode of Delivery - Paper or Electronic
1058 837 Institutional and Professional - Request to change name of EPSDT Referral segment
1059 Request to use K3 Segment
1060 835-Establish limit for CLPs per transaction set
1061 275 - Attachments TR2
1063 835 - Add clearinghuse versus direct delivery for how the claim was submitted
1064 835 - Allow Credit Card Payments in the 835
1065 835-Enhance guidance on COB for line level secondary payments
1066 835 - Front Matter section 1.10.2.11 Enhance directions for procedure code
1067 835 - Revise Correction & Reversal Front Matter Section 1.10.2.8
1068 835-Review examples in Section 3
1070 835 - Front Matter Section describing detail on NO PAY situations
1072 835 - must be TR3 compliant regardless of the claim source
1073 835-New Front Matter Section Describing HIPAA Requirements for providing 835
1074 835-Section 1.10.2.22 Billing Provider as Payee Additional Guidance
1075 835 - reorganize all Front Matter sections
1076 835-Front Matter Section on handling out of balance situations
1077 835 - Section 1.10.2.24 revisions
1078 835 - Need direction on Bonus and Penalty usage
1079 Add Clarification on RAS Composite Elements
1080 835 - One claim, allow the both institutional and professional claim related data
1081 835 - NM1 Subscriber TR3 Note - ensure the intent matches the 837
1082 835 - Corrected Patient/Insured - Add Implementation Name/Definition and update rules
1083 835-PLB Capitation codes - remove the restriction on some codes
1084 835 - Expand front matter section for use of PLB code FB
1085 835 - REF Service Identification - add usage notes for codes E9 and G3
1086 835 - REF Qualifier G1 - revise code value note
1088 835 Section 1.10.2.11 Split Claims and restriction on useage
1089 835 - Clarify TS3 Totals
1090 835-DSMO request 1173 to add monetary elements back to TS3 segment
1091 835 - Modify Section 1.10.2.6 Bundling for non-paying service lines
1092 835-SVC Units note make consistent with 837 note
1093 all books - Standard use of UNITS
1094 835 - Section 1.10.2.7 Predetermination revisions
1095 835 - DTM Claim Received Segment - modify situational rule
1096 835 - Update section 1.10.2.13 for use of OA-23
1097 835-Front Matter / Clarification for "Public Goods Funds", i.e. Bad Debt
1098 835 and 837 - remove CR Claim Status Code
1099 835-Update usage of PER to allow for secure websites
1100 835-Remove AMT T2 qualifier
1101 835 - Add Element Note to 1000A N102 with CCD+ Name requirement
1102 835 - TIN required in the 835 when NPI is primary ID
1103 835-Review Balancing Section for Professional Claims
1104 278 - Transport Location Categories
1105 835 - Diagnostic Related Group Code Situational Rule
1106 ICM03 - Member Income Segment
1107 Prior Incorrect Member Implementation Name
1108 Using a general segment/element to accomodate data needed but not explicitly defined in the TR3
1109 HL01 - Hierarchical ID Number
1110 X307 (HIX 834) Loop 2000 Coverage Specific Issuer Assigned (REF)
1111 INS04 - Maintenance Reason Code - Update Situational Rule
1112 2100A/NM108 - SSN Qualifier Note
1113 2100F/Custodial Parent 1st Name
1114 Allow for More Contacts in PER Locations
1115 Pregnant Indicator
1116 Add dates to HLH - Health Related Code
1117 HLH - Situational Rule Change
1118 Remove 997 Reference From Front Matter
1119 Differentiate the Patient Account Number and the Provider Assigned Claim Identifier
1120 Add Clearinghouse Entity to Claim Status Guides at Claim & Service Levels
1121 277CA - Require Accepted Claim Number
1122 278 - Health Care Services Review - Request for Review and Response: Requester Name is not aligned between the request and response.
1123 837 All Claim Guides - Change SVD01 DE to match SBR01
1124 278 - X278 Request and Notification, CR6 TR3 note specifies icd9 principal DX - no mention of icd10. Remove TR3 Note
1125 278, all guides add dental examples to section 3
1126 X278 Notification, Section 1.4.1, Should be plural at the end of the sentence. "business functions supported by the ASC X12 health care implementation guides." change guide to be plural
1127 278 - X278 Request, Section 2.4 2000E HSD05. Situational Rule type "timeframe". Change to "time frame".
1128 X278 Request, Section 3.4.1 Patient Event level, add day and month to comment. CR6*1*20130502*RD8 *20130502-20130801***W*I~
1135 837P, 837D, 835 - Rendering provider changes
1137 837 - All Claim Guides - Remove Claim Adjustment Group Code "CR" from the 837 guides.
1138 835 - Allow PER segment to report a secure web site
1139 835 - Remove qualifier T2 from the AMT segment at both the 2100 and 2110 loops
1140 835 - Section 1.10.2.8 Reversal and Correction to clarify the order of R&C
1141 Include 'Syntactical Errors' in the Purpose and Scope
1142 999 - X12C suggested change to reference to standard
1143 999 - X12C suggested change to clarify industry related verbiage
1144 999 - X12C changes to verbiage for the related transactions
1145 999 - X12C request to use the diagram 1b from ARM
1146 999 - X12C suggested verbiage change for ST gray box note
1147 999 - X12C suggested verbiage change to clarify 35 character limitation
1148 999 - X12C suggested change to IK402 situation rule verbiage
1149 999 - X12C request to add examples that show RFI related acknowledgements.
1150 All 5010 TR3s - HPID/OEID requirements to align with final rule
1151 271 - Response Must Address Date sent in 270 Request
1152 834 Data Dictionary
1157 Modify Attachments tx (X275) to accommodate HPID/OEID requirements to align with final rule
1158 Modify Health Insurance Exchange Related Payments to accommodate HPID/OEID requirements to align with final rule
1159 Modify 5010 non HIPAA transactions to align with HPID/OEID requirements
1160 Update current products in development & all future txs to accommodate HPID/OEID
1161 DSMO Request 1185
1164 835 BPR01 - Transaction Handling Code - Value K - Reimbusement to Follow
1173 837 All Guides - Change CLM01 Element Note 3
1174 835 - Facility Type Code maximum increased.
1175 835 - Add transition language to CLP02 Code 'RO'
1176 835 - DRG Codes length
1177 835 - Subscriber Primary Identifier typographical error
1178 835 - Subscriber Primary Identifier
1179 835 - Corrected Patient/Insured Name
1180 835 - Rendering Provider Primary Identifier
1181 835 - Location Identifiers
1182 835 - Corrected Payer Primary Identifier
1183 835 - Other Claim Related Information 2100 REF
1184 835 - Other Claim Related Information 2100 REF repeats
1185 835 - Statement From or To Dates clarification
1186 835 - Corrected Onset of Current Symptoms or Illness
1188 Service Provider Name Entity Type Code
1189 276/277 - Service Date
1190 276/277 - Status Code (STC)
1191 276/277 - Service Status Line Information
1192 276/277 - Pre-determination of Benefits Indicator
1193 278 - Requester Primary Identifier (2010B NM108)
1194 278 - Diagnosis Type Code
1195 270/271 - Quantity Qualifier (EB09) NP – Number of Members
1196 276/277 - Status Code (STC)
1197 278 - Drug Unit or Basis for Measurement Code (DRG04)
1198 270/271 - MPI- Subscriber Military Personnel Information
1208 278 - Demonstration Projects/Waivers
1210 837 Dental Guide - Change Name for Section 1.12.2
1214 837 all claim guides - Payer Address and Other Payer Address not Allowed unless the Claim is to be Printed to Paper and Mailed to the Payer
1215 837 all guides - Subscriber Group Name not Allowed when the Group/Policy Number is Reported
1216 837 Institutional Guide - Remove references to Inpatient/Outpatient in Situational Rules and point to UB Manual
1217 837 Institutional Guide - Service Line Date only Allowed for Outpatient Claims
1219 270/271 - New Insurance Type Code - Open Access POS
1221 270 EQ02 - Add Procedure Code Range End and 4 Procedure Codes
1223 278, 270/271 - Loosen Restrictions on AAA/ECL AAA03?
1224 270/271 - Reduce Repeats of Procedure Code Elements to a Reasonable Number
1230 837s: Add Allowed Amount
1233 270/271 - Section 1.4.2 Accumulator and lifetime limits history of benefit use?
1234 Allow External Code lists for "Other Industry" Remark Codes
1235 270/271 - Section 1.4.4 TA1 generation - Batch Mode
1236 All Guides - Review/Modification of Loops, Segments, Elements and Codes for version transition where applicable
1237 270/271 - 6020 Requirements - 1.4.8.1.4 minimum of 10 service type code support requirement
1238 270/271, 278 - The unusability of the HSD segment
1239 271 BHT03 Semantic Note and Element Note do not agree
1240 270/271 - Section 1.4.8.2.8 - Align Service Type Codes listed to those mandated by CAQH Federal Operating Rules
1241 270/271 - Create a name for the list of benefits catalogued in Section 1.4.8.2.8
1242 270/271 EQ01/EB03 length issue
1243 270/271 - EQ01 Service Type Code duplication
1244 270/271 - Section 1.4.4 duplicates other sections
1245 270/271 - 1.4.8.2.1 - Date of Death required
1246 270/271 - Section 1.4.9.3 - Name/Date of Birth Search Option clarify
1247 270/271 - Section 1.4.9.4 - Member ID Number/DOB Search Option
1248 837 all claim guides - Allowed Amount/Other Insurance Allowed Amount
1249 837 all claim guides - Final Net Allowed Amount (Approved Amount)
1250 837 all claim guides - Request new DE 1166 CN101 Contract Type code
1251 Qualify all Diagnosis Related Groups
1252 Marry segments within the 271
1253 271 - Add X12 HIPAA code '756', defined as 'End of Grace Period' to the DTP Date/Time Segment
1254 99 Patient Requests per batch 270
1255 1 Patient request per Real Time 270
1256 270/271 - Add Service Type 4 (Xray) to Service Type 30 Response
1257 Add Tooth Number and Surface to the 270/271
1258 TR3 for Medical Information not as Attachment
1259 Drug Formulary Technical Report
1260 Services Review Propriatary Attachment Formats
1261 Correct Grammatical Errors in CICA Document
1263 Provider Tailored Benefits-236
1264 Date Range Support-291
1265 835 - Add Support for Credit Card Payments from Health Plans
1266 270/271 - Insurance Type Codes/Product Codes as an External Code List
1267 274 - Changes for pharmacy provider enrollment
1268 835 - New code value for data element 1032
1269 270/271 - Repeating EQ01?
1270 270/271 - Enhancement to EB14 modifiers for returning benefits related to a specific diagnosis on a 271 transaction.
1271 270/271 - Enhancement needed when the optional group (policy) number is used as search criteria on the 270: Need to return new group (policy) number error messages on the 271.
1272 270/271 - Allow EB03 and EB13 to be used in conjunction with each other on a 271 transaction.
1273 270-271 - Cascading Logic described with a matrix vs. bullets
1274 837 - Add Reference for an External Code Source for Collection of Census Codes
1275 Harmonize Code Lists that Categorize Payers
1276 270/271 - Dates Before Coverage Active
1277 270/271 - Legislation and Cascading Logic Requirements
1278 835 - DM 001187 Response
1279 270/271 - TA1 Required to be Supported?
1280 270/271 - Section 1.4.4 - Batch and Real-Time Limitations on Number of Requests
1281 270/271 - Create a Used Amount Code in the Time Period Qualifier Data Element 615
1282 999 AK102 Usage When GS06/GE02 Are In Error
1283 999 AK203 usage when ST03 is invalid
1284 999 AK202 Usage When ST02/SE02 Are In Error
1285 999 AK103 Usage When GS08 Is In Error
1286 270/271 Section 1.4.2 - First sentence is dated
1287 999 AK201 Usage When ST01 Is In Error
1288 999 - TA101 Usage When ISA13 or IEA02 Is Invalid
1289 TA101 Usage When ISA13 or IEA02 Is Invalid
1290 270/271 Section 1.4.8.4 - 'Data vs. Information' Verbiage
1291 999 AK101 Usage When GS01 Is In Error
1292 270/271 Section 1.4.8.2.10 & 1.4.8.2.11 - Returning Relevant Benefits
1293 270/271 Section 1.3.2 Batch & Real Time - First sentence in first paragraph of each section
1294 270/271 Section 1.4.3 - Sentence rewrite
1295 270/271 Section 1.4.2
1296 270/271 Section 1.4.4 - Proprietary Error response
1297 270/271 Section 1.4.8.2.1 - Clear definition of Terminated coverage is needed
1298 270/271 Section 1.4.8.2.1 - Providing additional information not relevent to dates requested.
1299 270/271 - Usage of EB03 with a Service Type code descriptor
1300 270/271 Section 1.4.8.2.1 - Code used doesn't describe data element correctly
1301 270/271 Section 1.4.8.2.8 - EB03 and EB13 co-usage
1302 270/271 Section 1.4.8.2.12 - data / information word consistency
1303 270/271 - Ability to respond with Alternate Benefits
1304 270/271 - Ability to Identify Benefits that are shared across ServiceTypes and Procedure Codes
1305 270/271 - Flag on benefit to recommend conducting a predetermination
1306 270/271 - Ability to Identify a collection of procedures within a service type
1307 278 - Add DRA07 and DRA08 'Y/N' Indicators
1308 Unique Device Identifier
1309 270/271 - Ability to relate a benefit to a collection of other benefits
1310 Technical Report Type 3 - Provider Electronic Data Interchange Enrollment
1311 270/271 - Ability to identify tiered benefits for Network Participation and Product Line
1312 837P - Add an additional provider segment in the 837 Professional TR3 to report the substituted provider when reporting Locum Tenems as the Rendering Provider in the 2310B Loop
1314 Unique Device Identifier
1315 276/277 Subscriber Paid Claims
1316 Incorporate recommendations from v6020 public forums into ‘Common Content’.
1317 DSMO 1187 - 835 - Revise Section Section 1.10.2.13 for inconsistencies
1318 270/271 - 1.4.8.1.4 - Explicit Request for Eligibilty
1319 270/271 HPID
1320 270/271 - New value in the 271 for reporting authorization type
1321 837 Professional, Dental and Institutional - Change of situational Loop 2320/2430 AMT*EAF Remaining Patient Liability
1322 275 - Removal of UPIN from Provider Secondary Identification Segments
1323 270/271 - TRN notes
1324 270/271 - Section 1.4.3 - Funding Source
1325 Add field for version conversion
1326 835 - Inter-Governmental Transfer (IGT) Payments
1328 837 - Supply guidance in the 837 for 835 segments
1331 The 278 Notification does not support a CR109 to indicate the reason for the round trip ambulance request.
1332 278 - Common Content word clarification needed in grey note for GS01 and GS08
1334 837D - Remove the Sales Tax Amount segment from the Dental Claim
1335 834 - Race and Ethnicity Expansion Needed
1339 835 - Revise notes on CLP02 Claim Status Codes
1340 DM024112 - CICA TR3: Auto Insurance Financial Responsibilty Filing Notification
1341 Addition to P49_16 Financial Responsiblity Filing Purpose Code
1342 Payment Sequence Number in 835
1343 837 - All Claim Guides - State of Claim Jurisdiction (compliance state)
1344 State of Claim Jurisdiction (compliance state)
1345 278 - The TRN01 Code Value 2 Grey Note is misleading by using the term "originally"
1346 The TRN01 Code Value 2 Grey Note is misleading by using the term "originally"
1347 The TRN01 Code Value 2 Grey Note is misleading by using the term "originally"
1349 837 All Claim Guides - Modify claim referral number REF and Referring Provider situational rules
1350 Section 1.1 Implementation Purpose and Scope
1351 837I - Drop Patient Estimated Amount Due AMT segment
1352 Add Date/Time of Enrollment Application
1354 820: Revise Section 1.10.2
1356 Electronic Prior Authorization Process TR2
1357 270/271 - Add new error codes to Reject Reason Error Codes (AAA03)
1358 Move chapter 3 examples for all TR3s to an external website
1359 837 All Guides - Continue AMT segment capabilities for reporting taxes
1360 Maintain AMT segment capability for reporting taxes
1361 835 - Remove note 2 on PER WORKERS’ COMPENSATION PAYER WEBSITE
1362 HIX 820 Issuer Plan Identification
1363 X306 820- Modify REF "Exchange Assigned Employer Group Identifier" Situational Rule
1369 X290 Loop 2100/IK303 Remove note referring to loop identifier restiction.
1370 Remove 2100 CTX04 Note
1371 X290 Loop 2100/CTX04 Remove note referring to loop identifier restiction.
1372 X290 Loop 2110/CTX04 Remove note referring to loop identifier restiction
1373 X290 2100/CTX06: Change Situational Rule
1374 X290 Loop 2110/CTX06 Change situational rule.
1375 824 - Change CTX06 situational rule
1384 837 - Establish procedures for K3 usage approval and incorporation into future TR3
1385 Differentiate when Member has fully met Individual OOP vs. Zero accum to OOP Max
1389 278 – Providers need a way to report an Expedited request
1390 837R - 2310F — REFERRING PROVIDER NAME and 2310F Rendering Provider Name- TR3 note is wrong, (Loop 2420 doesn't exist)
1392 837P, 837D - Allow Prior Authorization number to be reported at the service line regardless if it has been reported at the claim level.
1395 1000A and 1000B N1, N3, and N4 Segment and Data Element Usage Correction
1398 Update CARC/RARC TR2 for Q1 2014 - DM A12014
1399 Add RxNorm Support to 270/271
1400 Harmonize the reporting of Diagnosis Related Group (DRG)
1401 ICD-10 Change - External Cause of Injury to External Cause of Morbidity
1406 Provide consistency and definitions for types of provider entities across guides
1408 HIX Premium Payment Grace Period Norification
1409 Correction in 837 institutional Guide
1410 X267: Disallow Negative Values
1411 Add new subsection to 835 Section 1.10 for Wire Transfer Payment & ERA Information Flow in 835
1413 837 Institutional/Reporting - Modify location of Auto Accident State Code for Consistency across TR3s
1414 835 - Front matter Delineation between different types of EFT in Section 1.10.1.3
1418 270/271 - Enhance benefit information request and response for prescription drugs
1419 837I - Change 2310D loop TR3 note #2 837R Change 2310D loop TR3 note #1
1421 835 - Loop 1000A Payer ID elements N103 & N104 - split situational rule note
1422 Require Payers to Support Procedure Codes on 270 Request
1423 Provide code usage notes
1425 Add HI Segment at the Service Level to all 278 Transactions
1426 Add HI Segment at the Service Level to all 278 Transactions
1427 835 wording in 1.10.2.10
1428 834: Allow ITIN in Loop 2100A NM109
1430 Transplant Donor Fields for 837I and 837P
1431 ONC Patient Matchinging Identification & Matching Initiative
1432 F request change to TRN
1433 Remove regulatory policy instructions from TR3s
1434 278 Provider NM101 Entty Identifier Codes Updates
1435 278 Requester Loop on the Response has a repeat of 2
1436 271 Convey Group Funding Type - Self or Fully Insured
1441 278 X315 correction to Addt'l Patient Information (Loop 2010EB)
1442 Request change to the TR3 Implementation Guide for the 835 transaction
1443 Align 820 with Language in 835 on Association of One Transaction to One Payment
1446 Easy detection of atypical providers
1448 837P CR1 segment/element notes and/or usage change
1449 835 SVC Situational Rule
1450 835 1.10.1.3 Clarify table and note
1452 835-TR3 Note 1 in 2100 NM1 Subscriber Name and NM1 Corrected Patient / Insured Name
1453 834 - Add Code ANC to HD03 Data Element 1205 Insurance Line Code
1454 837 COB linkage
1455 835- Update Implementation Name for BPR16
1457 835 - add DTP segment to the 835 transaction
1458 835-remove BPR04 note sentence on ACH, BOP, and FWT
1459 834: Require Accurate Reporting in 2100A LUI
1460 278 X315 PWK Segment in the Response - Correct Error in PWK TR3 Note 1
1461 835-Review Group Code Descriptions
1462 820 - Update BPR04 ACH, BOP & FWT Notes
1463 5010X220 has no notes in TR3 indicating no separators can be used in SS# or Employee's identification number
1464 Insurance Carrier and Lender/Tracker Request and Response
1466 835 section 1.10.2.13 defintion of CARC 23
1467 Add new binary data loop in standard to 824 TR3
1468 HCR01 code values in 278 transactions
1469 835 - Remove qualifier 4 from CLP02
1470 SVD X12 Set Note needs to be changed
1471 837 PWK02 usage
1474 6020 837P (x259) Examples to move forward for next version
1475 New Value for BPR04 to accommodate an interdepartment transfer of funds
1476 Add front matter section to point to the external acronym listing being developed by ASC X12.
1477 820: Re-evaluate Usage in the 1000A and 1000B Loops
1478 Qualifier & Code Note Synchronization
1481 837I - Remove Loop 2300 AMT-Patient Amount Estimated Due (F3 Qualifier)
1483 6020 837I (x260) Examples to move forward for next version
1484 6020 837D (x261) Examples to move forward for next version
1485 837I - Add HIxx-10 to the HI-Value Information, to be used for Value Code values that are not monetary amounts.
1488 6020 276/277 (x267) Examples to move forward for next version
1489 6020 277CA (x269) Examples to move forward for next version
1491 6020 277 Request for Additional Info (x313, formerly X268) Examples to move forward for next version
1492 Add Capability to Identify Member Level Dates for Discreet Medicare Parts
1493 6020 275 (x314) Examples to move forward for next version
1494 837P - Modify Situation rule Loop 2000B PAT Segment to refer to 2000B HL04 value to determine when the Patient is or is not the subscriber
1495 Update situational rule 308 - to be Required when 2000B SBR01 not equal to "P"
1496 Remove 837P 2300 DTP - Acute Manifestation Date
1497 Add Explicit Balancing Language for QTY and AMT Segments
1498 835-Correct spelling of "self-insured"
1499 835 Section 1.5 Business Terminology: Plan Definition
1500 835 - NM1 Corrected Patient / Insured NM103 grammatical error in situational rule
1501 Change Request to the 277 response to include contractual adjustment and patient responsibility along with harmony in 277 responses
1503 837I, 837R - Line Item Service/Assessment Date
1505 837I/837R/PACDR 837I - Remove the DA (Days) qualifier from HCP11 and SV204 (DE 355)
1506 Loop 2000C HL-Patient Level -Modify Situational Rule
1507 837P, PACDR 837P - Loop 2300 DTP Assumed and Relinquished Care Date needs to be 2 separate DTP segments
1508 Support direct Identification in the for interim or final response when a UMO requests more info for a Service Review
1510 277CA: Expand the Allowable Field Size of DE 782 Monetary Amount
1514 Various Date Change Requests
1515 Code Value Notes in the 820
1517 Update the Front Matter in the 266 Implementation Guide for the Due But Not Billed
1519 PACDR guides - Changes to Loop 2300 CLM01 to match the 837 transaction changes in 6020
1520 Patient’s Reason for Visit Examples
1521 837P Loop 2300 DTP Admission Date change situational rules when required
1522 837P - Modify Situational Rule on Loop 2300 DTP- Discharge Date
1523 837P - Modify Situational Rules on Loops 2310E/2420G- Ambulance Pickup and 2310F/2420H Ambulance Drop Off
1524 835-Clarify situational rule on 2100 NM1 Corrected Priority Payer Name segment.
1525 All 837 PACDR Guides - Remove redundant usage note
1526 275 7030 example for unsolicited attachment
1527 837P/I/D - 2010AC - Change to situational rules
1528 837P / 837D - DTP - Accident Date and CLM11
1529 837P - 2400 PWK
1530 837P - Required when a Certificate of Medical Necessity (CMN) or DME Information Form (DIF)
1531 837P / 837D - 2400 CN1
1532 837P - Purchased Services (Loop 2400 AMT)
1533 837D - 2000A PRV
1534 837D - 2300 Service Date (DTP)
1535 All 837 PRV Segments
1536 837D - SV311
1538 837: REF04 Situational Rules
1539 275: Modify the Situational Rule for the 2000A REF Segment
1540 275: Modify 1000C REF Situational Rule
1541 834: Review/Revise Situational Rules for Consistency
1542 835 - Code Note Review
1544 Situational Rules in the 820 - Situational Rule 12090
1545 DSMO 1192 Medicare Subrogation
1546 Add code value 53 from DE1069 to the 278 transaction (and others)
1547 837I, 837R and PACDR Institutional 2310C - Other Operating Physician Qualifier (NM101=ZZ) needs to be changed to OOP - Operating Physician
1548 Add the device identifier (DI) of the Unique Device Identifier (UDI) to the Health Care Claim Remittance/Advice (835), Professional (837P), Institutional (837I), Eligibility (270/271), Inquiry and Response (278), Notification and Acknowledgement (278) and Request for Review and Response (278) and PACDR guides
1549 276/277: Modify Situational Rules for Subscriber Level DMG and TRNs
1550 276/277 - Modify 2000E HL Situational Rule for lingage to 2000D HL04=1
1551 Acknowledgment tx needed for 834 Member Reporting
1553 Removal of BHT03 Size Limitation of 30 characters
1554 276/277 - Modify 277 2100A PER (Payer Contact) to be a Required segment
1555 Add Certification Date to 834
1558 Review Code Notes
1559 837 Data Reporting (837R) - Replace ZZ qualifier with BUR (DE1270) in Loop 2300 HI Standard Occupational Classification System (SOC) in the HI01-01
1560 274 (x207) Changes for Provider Directory to include elements for MAO reporting
1563 Review Code Notes
1565 Clean Up TR3 Front Matter Re: Additional Service Review Information
1568 Need PLB code for Interest amount not included in the 835 AMT*I
1570 Consistency for Code Notes regarding NPI (XX qualifier) across TR3's
1571 Create Auto Insurance Notification TR3
1572 837P - 2400 AMT - PURCHASED SERVICE AMOUNT example
1573 Attachment Filter Enhancement
1575 834 First Name Required in Some Loops
1576 Create a TR2
1577 Modify Source for Code Source 51 - ZIP Code
1593 Code Note changes for Additional Information to Support a Health Care Claim or Encounter (275) and Additional Information to Support a Health Care Services Review (275)
1594 270/271 Code Note Review
1595 Additional Information to Support a Health Care Services Review (275) Code Note Review
1596 Implementation Acknowledgement for Health Care Insurance (999) Code Note Review
1597 Code Note changes for 274 Healthcare Provider Directory (x207) and 274 Healthcare Provider Information (x206)
1598 Add UDI Values to 275 Transaction Set and Applicable Technical Reports
1599 Expand the ASC X12 Change Requests System to have check boxes for Transaction Sets and Type 1 and Type 2 (and Type 4?) Technical Reports
1600 835 - CLP05 Situational Rule
1601 835 - LX segment situational rule update
1602 837 I, P, D 2320 AMT situational rule
1603 Capture frame and/or lens information that was dispensed during office visit by provider
1604 Capture manufacturing information for contacts
1605 Situational Rules in the 820 - Situational Rule 12138
1606 820: Revise Situational Rules
1607 X212 5010 version 276. Update DMG03 with U - Unknown
1608 Add link to X12 Store in TR3 section 1.6 Transaction Acknowledgments
1609 Prohibit use of TA1 for real-time transactions
1612 Correct SVD segment in PACDR 5010 guides
1613 824 - Add Guidance on Error vs. Warning Codes (Code Source 895)
1614 X344 (271 Grace Period Premium Payment Notification) Identify the type of a premium payment grace period within health care
1615 Code maintenance on Data Element 235
1616 CLP11 Semantic Note Update
1617 278 X315: Support Situational Rule wording for the SV segments
1618 278 X315: Support Situational Rule wording for the CR6 segments
1619 278 X315: Support Situational Rule wording for the REF segments
1620 278 X315: Support Situational Rule wording for the CRC segments
1621 278 X315: Support Situational Rule wording for the PWK segments
1622 278 X315: Support Situational Rule wording for the CL1 segments
1623 278 X315: Support Situational Rule wording for the CR1 segments
1624 278 X315: Support Situational Rule wording for the CR2 segments
1625 278 X315: Support Situational Rule wording for the CR5 segments
1626 278 X315: Support Situational Rule wording for the HI_Add segments
1627 278 X315: Support Situational Rule wording for the HI_Dx segments
1628 278 X315: Support Situational Rule wording for the NM1 segments
1629 278 X315: Support Situational Rule wording for the DRA segments
1630 278 X315: Support Situational Rule wording for the DTP segments
1631 278 X315: Support Situational Rule wording for the HCR segments
1632 278 X315: Support Situational Rule wording for the PRV segments
1633 278 X315: Support Situational Rule wording for the UM segments
1634 278 X315: Support Situational Rule wording for the AAA segments
1635 278 X315: Support Situational Rule wording for the BHT segments
1636 278 X315: Support Situational Rule wording for the HLSS segments
1637 278 X315: Support Situational Rule wording for the HSD segments
1638 278 X315: Support Situational Rule wording for the NM1 Additional Service Info segments
1640 278 X315: Support Situational Rule wording for the NM1 Service Provider segments
1641 275 X316: SVC02 Monetary Amount should not be required attachment data for Utilization Review determinations
1642 277CA, 276/277 - Add capability for reporting a 'Transferred To Entity' when a claim is transferred or forwarded
1643 Add REF to 271 2120 Loop
1645 Consistency needed for terminology, i.e. hyphen vs no hyphen in "post adjudicated"
1646 Add CN1 segment at line level for 837 Institutional
1647 HCR03 Error message code limitation of values.
1648 820 Balancing
1651 Issuing non-claim payments (i.e. incentive payments, alternative payment models payments, P4P payment etc.)
1652 Inclusion of Device Identifier (DI) portion of the Unique Device Identifier (UDI) in claims transactions
1654 ADP24: Remove Ambiguity
1655 Create Situational Rules in 274 Health Care Provider Information X206
1656 Provide More Detailed Explanations of X12 Transactions "Business Units" and Their Identifying Values
1657 Implementation Max Size Limit Presentation
1658 The X12 270/271 TR3 Section 1.4.16 should be updated with new content as follows: