Section title: Requests for Interpretation
271 Response handling of STC-specific information in MSG segments after STC EB segments are consolidated for compliance

From 271 response data auditing, it was observed by CMS that EB segments should be consolidated with a separator when the data element values are the same except for EB03. If they are not, this invokes a compliance issue of duplicate EB segments.

When attempting to consolidate the EB segments for Service Type Codes with identical EB data, an issue arises because our organization uses the MSG segments to send STC-specific URLs. The STC EB data is identical, but these URLs are not. The URLs cannot be sent in individual MSG segments because another compliance error occurs where there can only be a max of 10 MSG segments between.

How can we best go about continuing to send STC-specific URLs in the MSG segments while programming to consolidate the duplicate EB segments? Is one of the compliance issues more important to solve for than the other (i.e., duplicate EB segments vs. more than 10 MSG segments between EB segments)?

Something similar was touched upon in RFI #2432, but the MSG data in this scenario is not repeating detail found elsewhere in the 271 response.


Example below is of consolidating duplicate EB segments to resolve the related compliance error below while attempting to send individual unique MSG segments by STC. This proposed solution causes an error with too many MSG segments per EB segment.



~MSG*Link=Detail 23


~MSG*Link=Detail EE


~MSG*Link=Detail EA


~MSG*Link=Detail 41


~MSG*Link=Detail EF


~MSG*Link=Detail EI




RFI Response

The last sentence in 2110C EB Segment Note number 3 specifically says: “…the repetition use of EB03 must be supported if all other elements in the 2110C loop are identical.”

Because the MSG segment is part of the 2110C/D loop, and because the URLs are different for the different services or benefits returned in 2110C/D EB03, you cannot use the repeating data element function.

To compliantly use the repeating data element capability, everything must be identical with the only exception being the EB03; this means the entire 2110C/D loop, inclusive of the 2115C/D and 2120C/D segments and their elements (as they are nested loops within 2110C/D).

This same note exists on the 2110D EB, as Segment Note number 3 as well.

URLs (or links) should be sent in a PER segment in the 2120C/D loop assuming the use case fits the requirements for using the 2120C/D segments)

Please note, the service type code values used in the example above (EE, EA, EF, EI, EH) are not valid for the 5010X279A1 version of the 270/271 and must not be used.