2300/HI01-5 is defined as element type “R” (decimal), however value code A0 requires a zip code (which is not always a decimal) to be reported per the CMS manual for transmittal 437. The example from the CMS guide isHI*BE:A0:::12345~. How can a claim submitter enter a zip code with a lead 0 (ie. 01234) if HI01-5 is of type R (decimal) since Decimal does not allow lead zeroes? Does the receiver need to thus allow a numeric value with lead zeroes? (Previous RFI's asked a similar question but not exactly the same as this one)
When interpreting the X12 Standard, the Receiver must allow the leading zeros.The Standard X12.6ApplicationControl Structurestates the followingwith regards to leading zeros:Section 3.5.1.2 -Under the definition of decimal number."Leading zeros should be suppressed unless necessary to satisfy a minimum length requirement."The word “should” indicatesa recommendation; the word ‘shall’ indicates a requirement. Based on this description, the example above 01234 is acceptable to be carried in the "R" (decimal) data type.FURTHER DISCUSSION:With regards to the Technical Report Type 3(Implementation Guide), this issue was unintentionally created by using the Monetary Amount data element for non-monetary information with Value Codes. This will be fixed in the next guide. Section B.1.1.3.1.2 of the guide states in the third paragraph "Leading zeroes must be suppressed unless necessary to satisfy a minimum length requirement." As a result, senders cannot be forced to send leading zeroes in the Monetary Amount data element, since its minimum length as identified in the technical report is 1 character. Section 2.2.1.1 states "The receiver will handle non-compliant transactions based on its business process and any applicable regulations." See RFI # 1512 for related information.RECOMMENDATION:Until corrections are made with the next guide, receivers mustallow, but not require, leading zeroes in HIxx-05 when the related value code in HIxx-02 is "A0", indicating Zip Code, and the leading zero(s) are necessary to identify a complete Zip Code.