Section title: Requests for Interpretation
RFI #
1397
ANSI 837P ZIP CODE LENGTH
Description

We are being told that we need 9 digit zip codes for patient and subscriber addresses in the 2010BA subscriber name and the 2010CA patient name when the loop is present. These are the zip codes in the N4_03 data element. I thought that the 9 digit zip codes were only required when the note in the segment indicates it. These notes are found in the 2010AA billing provider N4_03 and the faciilty address in the 2310C facility service location.

RFI Response

The 5010X222A1 TR3 does not require a 9 digit ZIP code be reported in the 2010BA or 2010CA N403 data element. The value reported must only be a valid ZIP code or Universal Postal code from Code Sources 51 or 932 respectively. A 9 digit ZIP Code is only required when the N4 data element has this note: “When reporting the ZIP code for U.S. addresses, the full nine digit ZIP code must be provided.”

DOCUMENT ID
005010X222A1