Section title: Requests for Interpretation
RFI #
1752
276/277 Status for Paper Claim
Description

If the 277 Health Care Information Status Notification (005010X212) is used to respond to a 276 Claim Status Request and the claim involved was originally submitted as a paper claim, how should the value of REF02 Bill Type Identifier in loop 2200D (REF01="BLT") be formatted?
Can it mimic the value from the paper claim, i.e. have a leading zero, like "0131"?
Or should it be sent without the leading zero as if the origninal claim had been submitted electronically, like "131"?

RFI Response

The 005010X212 guide defines the2200D/E Bill Type Identifier (REF02, where REF01=BLT) as the concatenated value of the Facility Type Code (CLM05-1) and the Claim Frequency Code (CLM05-3) of the 837. Since the CLM05-1 sub-element has a maximum of 2 bytes and CLM05-3 has a maximum of 1 byte, and to maintain consistency between the electronic transactions, the Bill Type Identifier in the 2200D/E of the 005010X212 would be reported as a 3 byte value (e.g. 131).

DOCUMENT ID
005010X212