Section title: X12 EDI Examples
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ASC X12 Version: 008010 | Transaction Set: 278 | TR3 ID: 008010X342

Business Scenario - DME Rental and DME Purchase request with multiple px codes

A Provider submits an initial request for Durable Medical Equipment (DME) rental and DME Purchase for multiple procedure codes using the X342 8010 version.

Inbound Transmission Explanation

ST*278*1001*008010X342~

Submitter transaction Identifier

BHT*0007*13*16139462398*20200624*0734~

HL*1**20*1~

Payer Loop

NM1*X3*2*PAYOR A*****PI*1234567~

HL*2*1*21*1~

Requesting Entity Loop

NM1*1P*1*PCPLASTNAME*PCPFIRSTNAME****XX*1234567899~

Requesting Entity

PER*IC*CONTACT NAME*TE*5556368147*EX*551~

Contact Name and other information

HL*3*2*22*1~

Subscriber Loop

NM1*IL*1*LASTNAME*FIRSTNAME****MI*MEMBERID~

Member Data

DMG*D8*19470701*M~

HL*4*3*EV*1~

Event Loop

UM*HS*I**12:B**E~

Health Services, Initial, Home, Elective

DTP*AAH*D8*20200702~

Event Date

HI*ABF:C189~

Diagnosis

MSG*ADDITIONAL INFORMATION CAN BE PROVIDED IN MSG~

Additional information

NM1*71*1*PROVIDER*ATTENDING****XX*1234567899~

Event Provider role identification

NM1*SJ*2*ABC DME EQUIPMENT*****XX*1234567888~

HL*5*4*SS*0~

Service Loop

UM*HS*I*12~

DTP*472*RD8*20200702-20201002~

SV1*HC:K0813~

PX code= K0813, DME Purchase x1 starting on 7/2/20

HSD*FL*1

HL*6*4*SS*0~

Service Loop

UM*HS*I*18~

DTP*472*RD8*20200702-20201002~

SV1*HC:E0940~

PX code= E0940, DME Rental for 90 Days starting on 7/2/20

HSD*DY*90~

SE*28*1001~

Outbound Transmission Explanation

ST*278*0001*008010X342~

Submitter transaction Identifier

BHT*0007*11*16139462398*20200624*07344807*19~

HL*1**20*1~

Payer Loop

NM1*X3*2*PAYOR A*****PI*1234567~

HL*2*1*21*1~

Requesting Entity Loop

NM1*1P*1*PCPLASTNAME*PCPFIRSTNAME****XX*1234567899~

Requesting Entity Contact Name and other information

HL*3*2*22*1~

Subscriber Loop

NM1*IL*1*LASTNAME*FIRSTNAME****MI*MEMBERID~

Member Data

DMG*D8*19470701*M~

HL*4*3*EV*1~

Event Loop

UM*HS*I**22:B**E~

Health Services, Initial, Home, Elective

HCR*A4**0V~

Certification Action Code

REF*NT*5554772110000000~

Administrative Reference number

DTP*AAH*D8*20200702~

Event Date

HI*ABJ:C189~

Diagnosis

NM1*71*1*PROVIDER*ATTENDING****XX*1234567898~

Event Provider role identification

NM1*SJ*2*ABC DME EQUIPMENT*****XX*1234567888~

HL*5*4*SS*0~

Service Loop

UM*HS*I*12~

HCR*A4**0V~

Certification Action Code

REF*NT*5976434110000000~

Administrative Reference number

DTP*472*RD8*20200702-20201002~

SV1**HC:K0813~

PX code= K0813, DME Purchase x1 starting on 7/2/20

HSD*FL*1~

HL*6*4*SS*0~

Service Loop

UM*HS*I*18~

HCR*A4**0V~

Certification Action Code

REF*NT*5976434110000000~

Administrative Reference number

DTP*472*RD8*20200702-20201002~

SV1*HC:E0940~

PX code= E0940, DME Rental for 90 Days starting on 7/2/20

HSD*DY*90~

SE*32*0001~