When a received claim is split out into separate claim reference IDs because of line level adjudication, does the response to a Claim Status inquiry have to concatenate all of the line level adjudicated claims back together into the original claim?
This issue is explicitly addressed in the 005010X212 guide. The element notes on 2200D/E STC04 for Total Claim Charge Amount indicate the total charge for the claim reported in the Status Response may be different than the original submitted charge due to claim splitting. The Data Element Glossary (E.1, Page 280) defines the Total Claim Charge Amount as 'The sum of all charges included within this claim.' Consequently, for claims that were split and the associated service lines were adjudicated on separate claims, service lines do not need to be concatenated back together on the same claim status response.
See Section 1.4.2.1 for guidance on data that must be returned (such as Patient Control Number) on each Claim Status Response to help the provider locate or re-associate the response claim status data with the request claim data