Medicare sends ASC X12 277 Claim Acknowledgments (ASC X12 277CAs). Sometimes the total claim or encounter charge amounts in an incoming ASC X12 837 transaction set are greater than the 10-character limitation allowed per Appendix B ( B.1.1.3.1.2) for data element 782 Monetary Amount, which appears in the ASC X12 277CA at 2200B STC04 (to report total submitted charges) and 2200B AMT02 (to report total amount accepted – AMT01 = YU, and total amount rejected – AMT01 = YY). Encounter charge amounts in particular can be very large, representing many services administered in a Medicare Advantage plan. Therefore, at times, Medicare needs to be able to report more than 10 characters in these data elements. Can Medicare report more than 10 characters in these data elements per the ASC X12 277CA TR3?
This issue is explicitly addressed in Section B.1.1.3.1.2 - Decimal. The 10 character limitation for data element 782 (Monetary Amount) is specific to 'guides under the rules promulgated under the Health Insurance Portability and Accountability Act (HIPAA).' At the time of this response, the ASC X12 277 Claim Acknowledgment 005010X214 is not a mandated transaction under HIPAA and therefore is not subject to the data element 782 limitation as defined in section B.1.1.3.1.2. The 277CA reports cumulative dollar amounts from the 837 and since the Monetary Amount (782) data element isn't currently limited by the common content Section B.1.1.3.1.2., the data element has a maximum length of 18.
If you have not already done so, a Change Request may be submitted to ASC X12 requesting clarification be added to the various monetary elements within the 277CA where cumulative dollars are being reported from the 837 being acknowledged and/or the Appendix B - Nomenclature Common Content section