According to the Health Care Information Codes detailed in the HI segments of Loop: 2300 - Claim Information, HI01-05 has the attribute "monetary" and is data type "R," decimal. B.1.1.3.1.2 Decimal states that "Leading zeros must be suppressed unless necessary to satisfy a minimum length requirement. Trailing zeros following the decimal point must be suppressed unless necessary to indicate precision. The use of triad separators (for example, the commas in 1,000,000) is expressly prohibited. The length of a decimal type data element does not include the optional leading sign or decimal point."
According to the NUBC Guidelines (2025 Edition), the Value Code 45 is a non-monetary value and indicates "The hour when the accident occurred that necessitated the medical treatment." These values are listed as 00 (12:00-12:59am), 01 (01:00-1:59am), 02 (02:00-02:59am), 03 (03:00-03:59am) and so on until 23 (11:00-11:59pm) or 99 (unknown).
Should the leading 0 be suppressed and accepted by payers in the 837I?
Providers attempted to send Value Code 45 as 2. The payer rejected the claim due to missing leading zero in the file as 02.
When interpreting the X12 Standard, the receiver must allow the leading zeros. The Standard X12.6 Application Control Structure states the following with regards to leading zeros: Section 3.5.1.2 - Under the definition of decimal number. "Leading zeros shall be suppressed unless necessary to satisfy a minimum length requirement." The word "should" indicates a recommendation; the word "shall" indicates a requirement.
Based on this description, the example above 02 is acceptable to be carried in the "R" (decimal) data type.
Receivers must allow, but not require, leading zeroes in HIxx-05 when the related value code in HIxx-02 is "45," indicating Accident Hour, and the leading zero(s) are necessary to identify a complete Hour (HH) value.
Related RFIs: 1750