The CTX - Segment Context segment should be used when the IK3 loop was triggered by a situational requirement and an error occurs at the segment level. The CTX - Element Context segment should be used when the IK4 loop was triggered by a situational requirement and an error occurs at the segment level. Is the intention of these CTX segments to be used only when an HIPAA level 4 error is present? Or can these be seen in HIPAA level 1, 2 or 3 errors. For example, if an inpatient claim is submitted without an admitting dx code, and a HIPAA level 2 error is assigned, is this considered a situational requirement and therefore the CTX should be returned, or is this more of a syntactical error?
We are looking for a way to identify when the CTX is expected to be returned so that we can ensure that the 999 we return is compliant.
The CTX is used when an error reported in an IK3 or IK4 segment is ambiguous without further information. The CTX identifies that a Situational Requirement applies and has been violated. CTX content disambiguates the cause of a reported error. CTX usage is documented in the Technical Report Type 3 - Implementation Acknowledgment for Health Care Insurance (999) ASC X12C/005010X231.
FURTHER DISCUSSION:
The classification of errors as "HIPAA levels" is not within the scope of X12 Standards.