Can you please confirm if it is compliant to reject a claim when the sequence is out of order?
A provider submitted a claim to a Primary Payer in Loop 2000B Segment SBR01 = P with the sequence of the 2320 Loops out of order.
Example
2320 SBR*T*18** *****MC~
2320 SBR*S*19*******CI~
The primary payer is rejecting the claim due to the sequence being out of order since the ‘T’ in the 2320 Loop is before the ‘S’ in the other 2320 Loop.
TR3 Section 1.4.3.1 states “The order of multiple subloops that do not involve hierarchical structure and that do have the same numeric position within the transaction is less important. Such subloops do not need to be sent in the same order in which they appear in this implementation guide.”
Also, Implementation of EDI Structures – Semantic Impact (X12.59) describes the semantic relationships inherent in the implementation of X12 structures, including the meaning that is to be associated with data due to their positioning within the exchange of information, and the data relationships that can be inferred from the data structure.
There is no requirement to order the sequence of the 2320 loops.
Related RFIs: 1564