Section title: Requests for Interpretation
RFI #
2118
Negative amounts -277 STC/SVC
Description

A clearinghouse/web portal vendor is rejecting 277 transactions coming from us stating the rejection is because the 277 has negative numbers in the 2200 STC and 2220 SVC elements representing monetary values. We see nowhere in the 276/277 005010x212 TR3 that supports a rejection for negative amounts; furthermore we find references to negative numbers in the appendix under the decimal explanation in B1.1.3.1.2. However on the SVC02 element, there is a note stating "This is the line item total on the current claim service status" and that 276 SVC02 has a note "This amount is the original submitted charge."

We are passing thru the amounts, as an example (dollar amounts changed), as follows:

STC*F0^107*20150514**-28133.5*-

...

SVC*NU^0121*-2660*-215.38****5~

...

SVC*NU^0250*-2792*-251.98****72~

Are negatives monetary amounts on the 2200 STC/2220 SVC prohibited? If so, where is this stated in 005010x212 specifically for these two segments?

RFI Response

While data element 782 (Monetary Amount) syntactically supports a negative value, the contents of the element in each specific use must always report an accurate business situation.

The semantic notes for both STC04 and SVC02 indicate these elements are reporting submitted charge amounts. To both report a negative value and be compliant with the semantic notes, the provider must have requested to make a payment to the payer.

DOCUMENT ID
005010X212