Applies to | Question | Response |
All | What is a code list? | A code list is a set of codes, with associated descriptions and other supporting information, that enables efficient, effective, and consistent communication between trading partners. |
All | What is an external code list (ECL)? | External code lists are established and maintained outside of the X12 EDI Standard either by X12 itself or by other organizations, such as the United States Postal Service or the Regenstrief Institute. |
All | Why are external code lists needed? | External
code lists are useful in many situations including when: • The list needs to be updated frequently • The list is applicable to electronic messaging defined by other standards developers and industry associations • The list is most effectively maintained by a specific set of voters instead of the full X12 membership |
All | Who uses external code lists? | The users of each external code list are specific to the intended purpose of the code list but usually represent various sectors of an industry or various touchpoints in a business process. |
All | Are X12's external code lists intended specifically for use in the transactions defined in its EDI Standard? | No, X12 encourages other standards developers and industry groups to use its code lists when they are applicable to reduce duplication and redunancy and encourage consistency and interoperability in the industries we serve. These uses are goverened by X12's fair use policies. |
All | Are X12's external code lists in the public domain? | No, X12's code lists are copyrighted intellectual property and their use is goverened by U.S. Copyright law and X12's fair use policies. More information is available at x12.org/products/ip-use. However, the code lists are viewable at x12.org/codes |
All | What X12 group is responsible for external code lists (ECL)? | X12 external code lists are maintained within the External Code List Oversight (ECO) subcommittee of the Registered Standards Committee (RSC). |
All | What is the RSC? | The
Registered Standards Committee (RSC) is responsible for development and
maintenance of X12 work products that won't be submitted to ANSI for
recognition as an American National Standard. The RSC is a peer to the Accredited Standards Committee (ASC) which is responsible for X12's work products that are developed under ANSI-accredited policies and procedures and eligible for recognition as an American National Standard. |
All | What is the ECO? | The X12 External Code List Oversight (ECO) Subcommittee, operating under X12's Registered Standards Committee (RSC), is responsible for the integrity and efficiency of X12's external code lists and oversight of external code list maintenance. The subcommittee is responsible for understanding best practices related to code lists across industries and for applying those best practices to X12's external code lists when applicable. |
All | Do the ASC and RSC operate under the same governance. | X12's corporate policies apply to both the ASC and the RSC. Each committee also operates under its own governance related to its specific activities. |
All | Where does the RSC fall in X12's organizational structure? | An organizational chart is avaialable at x12.org/sites/default/files/documents/cap02-x12-organizational-chart.pdf |
All | Where does the ECO fall in X12's organizational structure? | An organizational chart is avaialable at x12.org/sites/default/files/documents/cap02-x12-organizational-chart.pdf |
All | How can I get more information about the ECO? | Policies
and processes related to the ECO are available on X12's policy and procedure
page,
x12.org/sites/default/files/documents/cap12-external-code-lists_0.pdf Explanatory information is available on X12's Info Center page, x12.org/sites/default/files/documents/cap12-external-code-lists_0.pdf |
All | What is a code maintenance group (CMG)? | A
CMG is a subordinate group established by the ECO to maintain one or more
external code lists (ECLs). As a comparison, a CMG is similar to a task group
established by an ASC subcommittee. A CMG is established based on a statement of work and all activities undertake by the CMG must fall within that statement of work. |
All | How is a code maintenance group (CMG) identified? | Each CMG established by the ECO is assigned a unique identifier and a descriptive name. Some of the CMGs are also known by an acronym. |
All | Do all CMGs operate the same? | No,
CMGs operate consistently in some areas and individually in others. Review the information available on X12's policy and procedure page, x12.org/sites/default/files/documents/cap12-external-code-lists_0.pdf Review the information available on X12's Info Center page, x12.org/sites/default/files/documents/cap12-external-code-lists_0.pdf Or talk with a CMG chair or the ECO chair at an X12 Standing meeting. |
All | How can I find out more details about a CMG, like the operating methodology, meeting schedule, officers, etc.? | Each
CMG operates under a Charter. The ECO operates under a Constitution, and the
Board has established policies related to the maintenance of external code
lists. Review the information available on X12's policy and procedure page, x12.org/sites/default/files/documents/cap12-external-code-lists_0.pdf Review the information available on X12's Info Center page, x12.org/sites/default/files/documents/cap12-external-code-lists_0.pdf |
All | What does it mean if a CMG operates under the defined representative voting panel methodology? | This means the group's constituents are explicitly identified to ensure the broad interests of various implementers of the associated transactions and users of the codified information are represented. |
All | What does it mean if a CMG operates under the material interest voting panel methodology? | This means the group's constituents are materially interested parties who commit to participating in the group's maintenance activities. |
All | What does it mean if a CMG operates under the X12 member voting panel methodology? | This means maintenance requests are determined via X12's Code Maintenance Request (CMR) process. |
All | Are a CMG's minutes available to the public? | Yes, the CMG minutes are available on the meeting minutes page on x12.org, x12.org/resources/meeting-minutes |
All | What is CMG01 and why is it different than other CMGs? | When a new external code list (ECL) is established and in other special situations, a code list may be established that cannot be appropriately assigned to an established CMG. In that case, the ECO needs to establish a new CMG or revise the statement of work for an existing CMG. In the interim, CMG01, the Transitional CMG, assumes responsiblity for maintaining the code list. |
All | What is CMG01's operating methodology? | CMG01 operates as a Defined Representative Voting Panel, with the ECO constituents as the defined voting panel. |
All | What is the difference between an X12 member representative and a constituent? | An X12 member representative is an individual named by an X12 member to represent the X12 member's interests in certain X12 activities. A constituent is an individual, usually an X12 member's representative, that has met the requirements, for example attendance requirement, for specific privileges within an X12 group. The requirements are documented in the group's constitution or charter. |
All | What are the governance documents applicable to the ECO and CMGs? | •
CAP12 External Code Lists - corporate policies related to the ECO • RSC101 RSC Operating Manual - the operating policies of the RSC • RSC130 ECO Mission • RSC131 ECO Constitution - the specific policies of the ECO • Each CMG operates based on a specific charter Review the information available on X12's policy and procedure page, x12.org/sites/default/files/documents/cap12-external-code-lists_0.pdf Review the information available on X12's Info Center page, x12.org/sites/default/files/documents/cap12-external-code-lists_0.pdf |
All | Do you have to be an X12 member to participate in external code list (ECL) maintenance? | Most ECO and CMG constituents are X12 member representatives, however, in certain cases a limited number of non-member constituents can be named. Submit the X12 feedback form at x12.org/feedback for more information. |
All | How is an external code list (ECL) identified? | Each ECL maintained by X12 is assigned a unique identifier and a descriptive name. Some of the lists are also known by acronyms that emerge over time. |
All | What is a scope statement for an ECL? | A scope statement defines the purpose or intended use of the code list. All codes approved for inclusion in the list are required to align with the list's scope statement. |
All | Where is the scope statement for an external code list (ECL) posted? | The scope statements are posted on the ECL product page on
X12.org at x12.org/codes |
All | Are X12's external code lists (ECLs) established to meet a new or emerging need for consistent codes and messages? | Some of X12's external code lists are established to meet a new or emerging need within or across industries. Others are based on a list that was previously maintained within the X12 EDI Standard or that were previously maintained by another organization that no longer wishes to maintain the list. |
All | Are X12's external code lists (ECLs) specific to the healthcare industry | No, X12's ECLs are intended to support many industries. |
All | Are all of X12's external code lists (ECLs) published three times per year? | Yes, except new lists not yet available for use may be published more frequently. |
All | What elements are required in an external code list (ECL)? | Each entry in an external code list must define the code, the code's description, and an activation date. |
All | What elements aren't required but could be included in an external code list (ECL)? | Some entries in an external code list may include an extended description, technical note, deactivation date, or last maintenance date. |
All | What is a "code" from an external code list (ECL)? | A code is the value transmitted between trading partners to convey a specific message. |
All | Do codes in an external code list (ECL) change over time? | Once published, non-substantive wording changes may be applied but substantive revision is not permitted. |
All | What does the "description" tied to a code in an external code list (ECL) convey? | A
brief statement of the meaning the code is intended to convey to the
receiver. The statement must stand-alone to communicate a meaningful message
that can be interpreted consistently by trading partners. Follow-up or next step instructions are not permitted in ECL descriptions. |
All | What does the activation date tied to a code in an external code list (ECL) convey? | The date all trading partners must begin to support the code. Willing trading partners may support the code after the publication date and in advance of the activation date. |
All | How is the activation date tied to a code in an external code list (ECL) determined? | A CMG defines the activation date when a new code is added or a code's description is changed. A CMG can determine the activation individually based on each request or according to a schedule defined within their charter. |
All | What does the deactivation date tied to a code in an external code list (ECL) convey? | When a code has been deactivated, this is the date trading partners must discontinue using the code, unless X12 has granted an exception for transmissions describing past activity. |
All | How is the deactivation date tied to a code in an external code list (ECL) determined? | A CMG determines the deactivation date when a deactivation is approved. A CMG can determine deactivation dates individually based on each deactivation or according to a schedule defined within their charter. |
All | What does the last modified date tied to a code in an external code list (ECL) convey? | If a code's attributes have been revised, this is the date of the latest revision. |
All | Are the codes in an X12 external code list (ECL) assigned with implied meaning or intelligence? | No, the codes in an X12 ECL are assigned sequentially without implied intelligence. |
All | What does "maintenance" include? | Maintenance is any change to an external code list, including the addition of a new code, deactivation of an existing code, or a change to the wording of a code's description. |
All | How do I request a new code be added or an existing description be changed on an X12-maintained external code list (ECL)? | Each
X12-maintained code list has its own maintenance request form. Select a code
list on the ECL product page on X12.org at x12.org/codes to access the form. Note that not all the external code lists shown are maintained by X12. Different instructions may apply for maintenance requests impacting those ECLs. |
All | How do I monitor my maintenance request? | Each
X12-maintained code list has a maintenance request status feature. Select a
code list on the ECL product page on X12.org at x12.org/codes to access the status of pending requests. Note that not all the external code lists shown are maintained by X12. Different instructions may apply for maintenance requests impacting those ECLs. |
All | My organization prefers different wording for a description tied to a code in an external code list (ECL). Can I "personalize" it in my organization's implementation? | No, a description published in an ECL must be implemented exactly as it appears on the list. Adding proprietary codes, changing the published description, and issuing any instruction that changes the intended meaning of a code in instructions issued to your trading partners would represent an intentional violation of the copyright. |
139 | What does "adjusted" indicate? | Adjusted
indicates the claim or line item charge amount is different than the claim or
line item payment amount. The following list contains examples of
adjustments. • denied • zero payment • partial payment • reduced payment • penalty applied • additional payment • supplemental payment |
139 507 508 |
How does CMG03 determine the start date for a new code? | CMG03 sets the start date for a new code to one of several options, including immediately upon publication, five months after the new version of the list is published, or 9 months after the new version of the list is published. |
508 | Some Claim Status Reason codes include usage rules. Do implementers have to honor those usage rules? | When
a Claim Status Reason Code includes a specific usage rule, implementers must
follow those rules to be in compliance with the code list. For example, a code that states "Usage: This code requires use of an Entity Code" must be transmitted with an Entity code. |
139 507 508 |
When does CMG03 meet? | CMG03 meets at each X12 Standing meeting. |
139 507 508 |
Who maintains these external code lists? | These code lists are maintained by CMG03, a group that operates under the External Code List Oversite (ECO) subcommittee within the Registered Standards Committee (RSC). |
958 | Can the ECL 958 Service Type Codes be used with version 005010 implementation guides? | No, in version 005010 the Service Type Code list was an internal code list, published within the EDI Standard. The internal code list is replaced by the external code list (ECL 958) as of version 007030 of the EDI Standard. |