Section title: Requests for Interpretation
RFI #
1331
277CA 2200C and 2000D loops
Description

When 2200C loop has STC segment with STC03 as 'U', what option is in compliance with the TR3 :
1. loop 2000D with patient and claim information should not be sent;
2. loop 2000D with patient and claim information may be sent to report status of specific claims.

RFI Response

The intent of the provider level status (2200C Loop within each 2000C Loop) is to report provider level errors that caused that specific provider's group of claims to be rejected. It is not intended to be used for reporting a culmination of claim specific rejection statuses. When a Provider level status rejection occurs (2200C STC03 = U), the 2000C HL04 Code Value '0' is to be used. The HL04=0 value means that no subordinate HL Segments exist in the Hierarchical Structure related to this 'Parent HL'. Therefore the 2000D HL would not be reported.

DOCUMENT ID
005010X214