Section title: Requests for Interpretation
1.3.2 Other Usage Limitations Transaction Set Header/Trailer (ST/SE) (275)

1st Question: 275 submission for additional info to support a singular claim - One ST/SE per submission or 275 submission for additional info to support singular claim per ST/SE sent in the 275 submission. If the later, is their limitation on number of ST/SE?

1.3.2 Other Usage limitation states, "The 275 transaction structure does not allow submission of additional information in support of more than one request for a health care claim or encounter."

Is this statement to indicate only one Transaction Set Header/Trailer (ST/SE) per 275 submission.

As the next statement, “A separate Transaction Set Header/Trailer (ST/SE) must be sent for each attachment of additional information.”

This is followed up by statement that drives for attachments for singular claim within the Loop 2000A. “The 275 can support multiple sets of information for a single request for review. See Loop 2110B BDS Segment and the LX Segment at Loop 2000A for additional details.”


006020X314 | 275 file submission contains multiple ST/SE transaction sets, each contain multiple Loops 2000A. Complexity for payer matching to 275 TRN02 to 837x PWK06 singular claim.

RFI Response

The 275 only supports one claim per ST/SE and multiple ST/SE’s can be sent within the Interchange/functional group. There is no limitation on the number of ST/SE’s however you may want to verify the receiver of the file does not have any business limitations.

The intent of 1.3.2 is the 275 structure only supports one claim per transaction (ST/SE). If sending attachment data for multiple claims for a single patient, it is required that each claim be in a separate ST/SE or separate 275 transactions. While the 275 structure only supports one claim, it does support multiple documents per claim. The BDS segment only supports one document. For multiple documents for a single claim, it is necessary to report them in separate BDS segments therefore requiring the repeat of the LX loop.

The TR3 does not explicitly limit the size of the BDS segment or the number of LX loops.

RFI Recommendation

Trading partners may impose limits on the size of the segment or the number of loops in companion guides. For example, some payers are limiting the number of attachments (LX loops) to 10 per claim.