LocationX329 | Health Care Claim Status Request and Response
1.3 Implementation Limitations
ActionModify Chapter 1
1.3.2.1 Real-Time and Batch Transmissions, Real-Time Limitations, bullet 1.
CR 401Review Bullet 1 under Real Time Limitations. Revise for clarity and accuracy.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
Changed Section 1.4.4.1 STC Composite and Code Use Rules, last bullet to "The Information Source must provide detailed status information by making use of the entire Claim Status Code list."
CR 1387To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
1.4.4.1 STC Composite and Code Use Rules, add bullet

An Entity Code may also be identified in conjunction with a Health Care Claim Status code to further clarify the status message when the code does not specifically require its use.
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
1.4.3.2 The Service, paragraph 2.
CR 405Strengthen the verbiage in Section 1.4.2.2 to require the return of service line details.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
1.4.4.2 Status Response Levels, Loop 2200B - Information Receiver paragraph.
CR 407Review the Status Respsonse levels and modify as needed to increase consistency.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
1.4.4.2 Status Response Levels, last paragraph.
CR 1387To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
Section 1.4 Business Usage, paragraph 1 changed to "The ASC X12 Health Care Claim Status Request and Response (276/277) implementation guide addresses the paired usage of the 276 as a request for claim status and the 277 as a response to that request. The 276 is used to transmit request(s) to obtain the status of specific health care claim(s) within a payer's adjudication process. It can also be used to request status information on a previously submitted predetermination. The payer uses the 277 to transmit the current system status of those requested claims or predeterminations. Claim history parameters may vary by payers and systems.
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionAdd Chapter 1
Section 1.4.7 Predeterminations
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionAdd Chapter 1
1.4.4.3 Status Messaging for Subscriber Direct Paid Claims/Services
CR 1315Add a new front matter section with guidance on standard category/status code and payment information for subscriber paid claims.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
1.4 Business Usage, Figure 1.1, Remove reference to "997", changed to
(999 or other format)
CR 1118The 997 is no longer appropriate for healthcare transactions and should be removed from the front matter in the Claim Status Guides.  
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
1.4.6 277 Transaction Uses, Figure 1.2, Remove the "997" reference , changed to (999 Acknowledgment)
CR 1118The 997 is no longer appropriate for healthcare transactions and should be removed from the front matter in the Claim Status Guides.  
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionAdd Chapter 1
Section 1.4.8 - Payer Claim Control Number Search and Response
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
Modify 1.4.3.1 The Claim, Paragraph 1
The 276 and 277 Loop 2200 may contain different segments, with the exception of the TRN Segment (Claim Status Trace Number). However, the intent of the loop is similar in both transactions. The provider and payer may identify the claim within their respective system using different data. As a result, the segments used for the request (276) may differ from the segments returned in the response (277).
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
Modify 1.4.3.1 The Claim, Paragraph 3

Reassociation of the response to the original request is a necessity of the 276/277 paired transaction. The reassociation is accomplished with a unique trace or reference number identified in the TRN Segment (Claim Status Trace Number), Data Element (TRN02). This number is determined by the originator (Information Receiver) of the 276 and must be returned in the 277 by the sender (Information Source). The 277 response TRN02 must contain the same value that was submitted in the 276 request. The only exception for not returning the 2200D or 2200E TRN segment in the 277 is when a rejection status is reported at the Information Receiver Level. In this instance, the lower level (child) HL is not used. See Section 1.4.4.2 - Status Response Levels, for details on an Information Receiver Level rejection.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
Modify 1.4.3.2 The Service, Paragraph 1

The service information follows the claim data in Loop 2210 (Service Line Information) of the 276 and Loop 2220 (Service Line Information) of the 277. Some payers' adjudication systems support service line information. When the requester is inquiring on the status of a specific service, Loop 2210 must be populated in the 276. When the payer is reporting the status of a specific service, Loop 2220 must be populated in the 277.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
Modify 1.4.3.2 The Service, Paragraph 2, Add Paragraph 3 and 4.

Similar to the claim level, the provider may send general service data such as dates of service, amount and procedure codes in an effort to receive status on multiple services and claim with those same attributes. When the provider includes a service specific identifier, i.e. Service Line Item Identification (Line Item Control Number), they are indicating to the payer that the search and response be narrowed to a very specific service line on a previously submitted claim. Use of the Service Line Item Identification (Line Item Control Number) in the payer's service level search and matching criteria may be helpful in narrowing the response to the specific services for which the provider has requested status.

For Service line status requests and responses, the SVC segment (Service Line Information) is used to report the actual service (procedure) data. The SVC Segment is returned by the payer indicating the adjudicated procedure code.

Due to the payer's adjudication processes and policies, service line data may be changed as a result of bundling or unbundling. In this case, the service line(s) returned in the 277 may be different than those submitted in the 276. Procedure code bundling or unbundling occurs when a payer believes the actual services performed and reported for claim payment can be represented by a different group of procedure codes. Bundling occurs when two or more submitted procedures are processed using one procedure code. Unbundling occurs when one submitted procedure code is processed and reported back as two or more procedure codes.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response
1.4 Business Usage
ActionModify Chapter 1
Modify 1.4.3.1 The Claim, Paragraph 2

When claim status is requested, the provider supplies data that helps the payer locate the claim(s). The provider may send general claim data such as dates of service, claim amount or bill type in an effort to receive status on multiple claims with those same attributes. When the provider includes claim specific identifiers, such as the Provider's Assigned Claim Identifier or the Payer Claim Control Number, they are indicating to the payer that the search and response be narrowed to very specific claims. Use of the Provider's Assigned Claim Identifier in the payer's search and matching criteria may be helpful in narrowing the response to specific claims for which the provider has requested status. See Section 1.4.8 - Payer Claim Control Number Search and Response for specific search and response requirements when the Payer Claim Control Number is submitted in the 276 request.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response
1.5 Business Terminology
ActionAdd Chapter 1
Section 1.5 Business Terminology

Predetermination Status Request

A request for status on a claim that was submitted prior to services being rendered. The predetermination request would include all data necessary to find the predetermination within the payers system, except for date(s) of service. See the 837 TR3 for a definition of a predetermination.
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response
1.7 Related Transactions
ActionModify Chapter 1
Modify 1.7.1 The Claim (837), Paragraph 2

Submitting a claim, whether by using the 837 or another format, is the first step in the claim status request/response process. Certain data elements (e.g., the Provider's Assigned Claim Identifier, type of bill, dates of service, insured identifier, service provider identifier, and payer's claim number when available) found on the claim help locate a claim within a payer's adjudication system. When the provider initiates a claim status request, as many of these data elements as possible should be forwarded to the payer. With the exception of the payer's claim number, the source of this information is the provider's billing system.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100
ST - Transaction Set Header
ActionModify Data Element Note
Transaction Set Header/ST02 Transaction Set Control Number

Changed to "The Transaction Set Control Numbers in ST02 and SE02 must be identical. The number is assigned by the originator and must be unique within a functional group (GS-GE). For example, start with the number 0001 and increment from there. The number also aids in error resolution research."
CR 999Revise the ST02 notes across the TR3's to make them consistent.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100
ST - Transaction Set Header
ActionModify Data Element Note
Transaction Set Header/ST02 Transaction Set Control Number

Changed to "The Transaction Set Control Numbers in ST02 and SE02 must be identical. The number is assigned by the originator and must be unique within a functional group (GS-GE). For example, start with the number 0001 and increment from there. The number also aids in error resolution research."
CR 999Revise the ST02 notes across the TR3's to make them consistent.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0200
BHT - Beginning of Hierarchical Transaction
ActionAdd Data Element Note
BHT01
Used to specify the sequential order of HL segments. The HL loops in the data stream must comply with this sequential order. An HL parent loop must be followed by any subordinate child loops prior to commencing a new HL parent loop at the same hierarchical level.
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0200
BHT - Beginning of Hierarchical Transaction
ActionModify Data Element Usage
Header/BHT06 Transaction Type Code

Changed from Not Used to Situational.
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0200
BHT - Beginning of Hierarchical Transaction
ActionAdd Data Element Situational Rule
Header/BHT06 Transaction Type Code

Required when the request is for status on a predetermination of benefits. If not required by this implementation guide, do not send.
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0200
BHT - Beginning of Hierarchical Transaction
ActionAdd Data Element Code Value
Header/BHT06 Transaction Type Code

P5 - Predetermination - Medical
P6 - Predetermination - Dental
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0200
BHT - Beginning of Hierarchical Transaction
ActionAdd Data Element Code Note
Header/BHT06 Transaction Type Code

P5 - Predetermination - Medical

Use when the transaction is for a medical related predetermination (Professional or Institutional).
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0200
BHT - Beginning of Hierarchical Transaction
ActionAdd Data Element Note
BHT01
Used to specify the sequential order of HL segments. The HL loops in the data stream must comply with this sequential order. An HL parent loop must be followed by any subordinate child loops prior to commencing a new HL parent loop at the same hierarchical level.
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0200
BHT - Beginning of Hierarchical Transaction
ActionModify Data Element Usage
BHT03 Changed from Required to Situational.
CR 398Add guidance for how to link Claim Status Reject Responses back to the submitted claims.  
LocationX329 | Health Care Claim Status Request and Response | 277 | 0200
BHT - Beginning of Hierarchical Transaction
ActionAdd Data Element Note
BHT03 Added Element Note.
CR 398Add guidance for how to link Claim Status Reject Responses back to the submitted claims.  
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000A
HL - Information Source Level
ActionModify Data Element Note
Loop ID 2000A/HL01 Element Note

Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000A
HL - Information Source Level
ActionModify Data Element Note
Loop ID 2000A/HL01 Element Note

Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0900 | 2200A
TRN - Information Source Application Trace Identifier
ActionAdd Segment
277
Loop ID 2200A
TRN - Information Source Application Trace Identifier
CR 398Add guidance for how to link Claim Status Reject Responses back to the submitted claims.  
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000B
HL - Information Receiver Level
ActionModify Data Element Note
HL01 Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000B
HL - Information Receiver Level
ActionModify Data Element Note
HL01 Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000B
HL - Information Receiver Level
ActionDelete Data Element Code Note
Loop ID 2000B/HL04 Hierarchical Child Code

0 - No Subordinate HL Segment in This Hierarchical Structure

"Required when rejecting the status request for errors at the Information Source or Information Receiver levels."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000B
HL - Information Receiver Level
ActionDelete Data Element Code Note
Loop ID 2000B/HL04 Hierarchical Child Code

1 - Additional Subordinate HL Data Segment in This Hierarchical Structure.

"Required when reporting status responses at the lower hierarchical levels (i.e. Subscriber or Dependent)."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100B
NM1 - Information Receiver Name
ActionModify Data Element Situational Rule
NM103
Changed to "
Required when the identifier in NM109 is not sufficient for identification. If not required by this implementation guide, may be provided at sender's discretion, but cannot be required by the receiver."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100B
NM1 - Information Receiver Name
ActionModify Data Element Situational Rule
NM103
Changed to "
Required when the identifier in NM109 is not sufficient for identification. If not required by this implementation guide, may be provided at sender's discretion, but cannot be required by the receiver."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0900 | 2200B
TRN - Information Receiver Trace Identifier
ActionModify Segment Situational Rule
Required when an entire 276 transaction is rejected for errors at the Information Source or Information Receiver level. If not required by this implementation guide, do not send.
CR 407Review the Status Respsonse levels and modify as needed to increase consistency.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0900 | 2200B
TRN - Information Receiver Trace Identifier
ActionAdd Segment Note
Added TR3 Note 2.
CR 407Review the Status Respsonse levels and modify as needed to increase consistency.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200B
STC - Information Receiver Status Information
ActionModify Data Element Situational Rule
STC01-03, STC10-03, STC11-03
Changed to "Required when an entity must be identified to further clarify the status code in this composite data element. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver."
CR 371Clarify when Claim Status Codes require the transmission of an Entity Code.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200B
STC - Information Receiver Status Information
ActionModify Data Element Situational Rule
STC10 and STC11
Changed to "Required when additional status information is needed. If not required by this implementation guide, do not send."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200B
STC - Information Receiver Status Information
ActionAdd Data Element Code Value
PTP - Pay to Plan Name, TU - Third Party Repricing Organization (TPO).
CR 378Add Pay to Plan at the Information Receiver level.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200B
STC - Information Receiver Status Information
ActionAdd Data Element Code Value
O4 - Factor
CR 95The Property & Casualty industry needs the ability to report external entities who purchase accounts receivable assets on behalf of a payer (i.e. Factoring Agent).
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200B
STC - Information Receiver Status Information
ActionAdd Segment Note
Added TR3 Note 2.
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000C
HL - Service Provider Level
ActionModify Data Element Note
HL01 Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000C
HL - Service Provider Level
ActionModify Segment Situational Rule
Changed to "Required when status was not reported at the Information Receiver level (2000B HL04=1). If not required by this implementation guide, do not send."
CR 398Add guidance for how to link Claim Status Reject Responses back to the submitted claims.  
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000C
HL - Service Provider Level
ActionDelete Data Element Code Value
"0" - No Subordinate HL Segment in This Hierarchical Structure.
CR 398Add guidance for how to link Claim Status Reject Responses back to the submitted claims.  
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000C
HL - Service Provider Level
ActionModify Data Element Note
HL01 Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100C
NM1 - Provider Name
ActionModify Data Element Situational Rule
NM103
Changed to "
Required when the identifier in NM109 is not sufficient for identification. If not required by this implementation guide, may be provided at sender's discretion, but cannot be required by the receiver."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100C
NM1 - Provider Name
ActionModify Segment Repeat
Changed from 2 to 1.
CR 389Service Provider NM1: Revise the notes and loop repeat as the NPI mandate is now in effect.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100C
NM1 - Provider Name
ActionAdd Data Element Code Value
82 - Rendering Provider and 85 - Billing Provider.
CR 402Review Provider information requirements across levels. Provider information is often repeated at different levels in the transaciton
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100C
NM1 - Provider Name
ActionAdd Data Element Code Note
Loop ID 2100C/NM101/Entity Identifier Code

85 Billing Provider

Use when converting from earlier versions of this implementation guide unless the provider is otherwise defined by a Trading Partner Agreement as a Rendering Provider.
CR 1188Include a qualifier in the 2100C NM101 for use during the transition period between TR3 versions and add use instructions.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100C
NM1 - Provider Name
ActionModify Data Element Code Note
NM108 - Identification Code Qualifier

XX - Standard Unique Health Identifier for Health Care Providers (NPI)

Changed to "Use when the provider is in the United States or its territories and is eligible to receive a National Provider Identifier (NPI).
OR
Use when the provider is not in the United States or its territories and has received an NPI."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100C
NM1 - Provider Name
ActionModify Data Element Situational Rule
NM103
Changed to "
Required when the identifier in NM109 is not sufficient for identification. If not required by this implementation guide, may be provided at sender's discretion, but cannot be required by the receiver."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100C
NM1 - Provider Name
ActionModify Segment Repeat
Changed from 2 to 1.
CR 389Service Provider NM1: Revise the notes and loop repeat as the NPI mandate is now in effect.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100C
NM1 - Provider Name
ActionModify Data Element Code Value
82 - Rendering Provider, 85 - Billing Provider.
CR 402Review Provider information requirements across levels. Provider information is often repeated at different levels in the transaciton
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100C
NM1 - Provider Name
ActionAdd Data Element Code Note
Loop ID 2100C/NM101/Entity Identifier Code

85 Billing Provider

Use when converting from earlier versions of this implementation guide unless the provider is otherwise defined by a Trading Partner Agreement as a Rendering Provider.
CR 1188Include a qualifier in the 2100C NM101 for use during the transition period between TR3 versions and add use instructions.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100C
NM1 - Provider Name
ActionModify Data Element Code Note
NM108 - Identification Code Qualifier

XX - Standard Unique Health Identifier for Health Care Providers (NPI)

Changed to "Use when the provider is in the United States or its territories and is eligible to receive a National Provider Identifier (NPI).
OR
Use when the provider is not in the United States or its territories and has received an NPI."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000D
HL - Subscriber Level
ActionModify Segment Note
Changed to "When requesting and responding to claim status for both a subscriber and dependent(s) of that subscriber without a unique ID, the Subscriber HL Loop 2000D must be followed by the subscriber's claim status data, Loop 2200D. In this instance, HL04=0 would be used. The Subscriber HL Loop 2000D must be repeated prior to one or more of the Dependent HL Loop 2000E and their corresponding claim status data, Loop 2200E. In this instance, Loop 2000D HL04=1 would be used. See Section 1.4.3.3 for an example of this structure."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000D
HL - Subscriber Level
ActionModify Data Element Note
HL01 Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000D
HL - Subscriber Level
ActionDelete Data Element Code Note
Loop ID 2000D/HL04 Hierarchical Child Code

0 - No Subordinate HL Segment in This Hierarchical Structure

"Required when there are no dependent claim status requests for this subscriber."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000D
HL - Subscriber Level
ActionDelete Data Element Code Note
Loop ID 2000D/HL04 Hierarchical Child Code

1 - Additional Subordinate HL Data Segment in This Hierarchical Structure

"Required when there are dependent claim status requests for this subscriber."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000D
HL - Subscriber Level
ActionModify Segment Note
Changed to "When requesting and responding to claim status for both a subscriber and dependent(s) of that subscriber without a unique ID, the Subscriber HL Loop 2000D must be followed by the subscriber's claim status data, Loop 2200D. In this instance, HL04=0 would be used. The Subscriber HL Loop 2000D must be repeated prior to one or more of the Dependent HL Loop 2000E and their corresponding claim status data, Loop 2200E. In this instance, Loop 2000D HL04=1 would be used. See Section 1.4.3.3 for an example of this structure."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000D
HL - Subscriber Level
ActionModify Segment Usage
Changed from Situational to Required.
CR 398Add guidance for how to link Claim Status Reject Responses back to the submitted claims.  
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000D
HL - Subscriber Level
ActionModify Data Element Note
HL01 Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000D
HL - Subscriber Level
ActionDelete Data Element Code Note
Loop ID 2000D/HL04 Hierarchical Child Code

0 - No Subordinate HL Segment in This Hierarchical Structure

"Required when there are no dependent claim status responses for this subscriber."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000D
HL - Subscriber Level
ActionDelete Data Element Code Note
Loop ID 2000D/HL04 Hierarchical Child Code

1 - Additional Subordinate HL Data Segment in This Hierarchical Structure

"Required when there are dependent claim status responses for this subscriber."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0400 | 2000D
DMG - Subscriber Demographic Information
ActionModify Segment Situational Rule
"Required when the 2000D HL04 = 0. If not required by this implementation guide, do not send."
CR 1549Base the situational rules on the HL04 value, supporting non-subjective editing.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100D
NM1 - Subscriber Name
ActionModify Data Element Code Note
Loop ID 2100D/NM102 Entity Type Qualifier

2 - Non-person Entity

Changed to "Use when reporting a non-person entity in an employer-subscriber situation, such as Workers' Compensation or any other Property & Casualty claims."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100D
NM1 - Subscriber Name
ActionModify Data Element Code Note
Loop ID 2100D/NM108 Identification Code Qualifier

Code Value 24 - Employer's Identification Number

Changed to "Use when reporting the Employer's Identification Number for Workers' Compensation or any other Property & Casualty claims."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100D
NM1 - Subscriber Name
ActionModify Data Element Code Note
Loop ID 2100D/NM108 Identification Code Qualifier

II - Standard Unique Health Identifier for each Individual in the United States

Changed to "Use when the HIPAA Individual Patient Identifier is mandated for use."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100D
NM1 - Subscriber Name
ActionModify Data Element Code Note
Loop ID 2100D/NM102 Entity Type Qualifier

2 - Non-person Entity

Changed to "Use when reporting a non-person entity in an employer-subscriber situation, such as Workers' Compensation or any other Property & Casualty claims."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100D
NM1 - Subscriber Name
ActionModify Data Element Code Note
Loop ID 2100D/NM108 Identification Code Qualifier

Code Value 24 - Employer's Identification Number

Changed to "Use when reporting the Employer's Identification Number for Workers' Compensation or any other Property & Casualty claims."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100D
NM1 - Subscriber Name
ActionModify Data Element Code Note
Loop ID 2100D/NM108 Identification Code Qualifier

II - Standard Unique Health Identifier for each Individual in the United States

Changed to "Use when the HIPAA Individual Patient Identifier is mandated for use."
CR 1563Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0900 | 2200D
TRN - Claim Status Trace Number
ActionModify Segment Situational Rule
"Required when the 2000D HL04 = 0. If not required by this implementation guide, do not send."
CR 1549Base the situational rules on the HL04 value, supporting non-subjective editing.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0900 | 2200D
TRN - Claim Status Trace Number
ActionModify Segment Situational Rule
"Required when the 2000D HL04 = 0. If not required by this implementation guide, do not send."
CR 1549Base the situational rules on the HL04 value, supporting non-subjective editing.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Payer Claim Control Number
ActionAdd Segment Note
See Section 1.4.8 for Payer Claim Control Number Search and Response requirements.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionModify Data Element Situational Rule
STC01-03, STC10-03, STC11-03
Changed to "Required when an entity must be identified to further clarify the status code in this composite data element. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver."
CR 371Clarify when Claim Status Codes require the transmission of an Entity Code.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionModify Data Element Situational Rule
STC10 and STC11
Changed to "Required when additional status information is needed. If not required by this implementation guide, do not send."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionModify Data Element Code Value
Loop ID 2200D / STC01-03 (Entity Type Code)
Standardized (Added/Removed) Entity Type Codes in STC Segment at Claim and Service Levels.
CR 419STC: Standardize use of the same Entity Codes across the TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionAdd Data Element Code Value
O4 - Factor.
CR 95The Property & Casualty industry needs the ability to report external entities who purchase accounts receivable assets on behalf of a payer (i.e. Factoring Agent).
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionAdd Data Element Code Value
Loop ID 2200D/STC01-03

OOP - Other Operating Physician
CR 952Replace the ZZ qualifier with an explicit qualifier that identifies Other Operating Physician.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionModify Data Element Note
STC06 Adjudication Finalized Date

Changed to "This is the date of denial or approval for the claim. This date may or may not be the same as the payment effective date from the remittance advice (STC08). In the 835, the payment effective date is BPR16."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionModify Data Element Situational Rule
STC08 Remittance Date
and
STC09 Remittance Trace Number

Changed to "Required when the remittance cycle is complete and this claim is included on a payment that is reported in an 835 or paper remittance to the provider. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionModify Data Element Note
STC08 Remittance Date

Changed to "This is the payment effective date from the remittance advice. In the 835, this is the value in BPR16."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionModify Data Element Note
STC09 Remittance Trace Number

Changed to "This is the unique identification number assigned to the payment in the remittance advice for tracking purposes. In the 835, this is the value from TRN02."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionAdd Data Element Code Value
AY - Clearinghouse
CR 1120Support reporting of a clearinghouse entity code in the claim status guides. Support reporting of a clearinghouse entity code in the claim status guides.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200D
STC - Claim Level Status Information
ActionAdd Data Element
Loop ID 2200D / STC13 (Predetermination of Benefits Code)
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Institutional Bill Type Identification
ActionModify Segment Situational Rule
Changed to "Required when the information receiver wants to further define data related to a specific claim. If not required by this implementation guide may be provided by the sender but cannot be required by the receiver."
CR 415Review the usage for Institutional Bill Type.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Institutional Bill Type Identification
ActionAdd Segment Note
Use of this data as search criteria may vary by information source.
CR 415Review the usage for Institutional Bill Type.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Provider's Assigned Claim Identifier
ActionModify Segment Name
From:
Patient control number

To:
Provider's Assigned Claim Identifier
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Provider's Assigned Claim Identifier
ActionModify Segment Situational Rule
Changed To:
Required when the Provider's Assigned Claim Identifier was submitted on the claim. If not required by this implementation guide, do not send.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Provider's Assigned Claim Identifier
ActionModify Data Element Code Value
X1 - Provider Claim Number
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Provider's Assigned Claim Identifier
ActionAdd Data Element Note
REF02
This is the value from CLM01 of the 837.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Provider's Assigned Claim Identifier
ActionAdd Data Element Note
REF02
The maximum number of characters to be supported for this qualifier is 35. Characters beyond the maximum are not required to be stored or returned by the receiving system.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Pharmacy Prescription Number
ActionModify Segment Situational Rule
Changed to "Required when the information receiver wants to further define data related to a specific claim. If not required by this implementation guide may be provided by the sender but cannot be required by the receiver."
CR 415Review the usage for Institutional Bill Type.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Claim Identifier For Transmission Intermediaries
ActionModify Segment Situational Rule
Changed To:
Required when a transmission intermediary (clearinghouse or other) needs to attach their own unique tracking number. If not required by this implementation guide, do not send.
CR 392Create a shared situational rule for REF*D9.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200D
REF - Property & Casualty Claim Number
ActionAdd Segment
276
LOOP ID 2200D
REF - Property & Casualty Claim Number
CR 385Support the Property and Casualty industry need for a P&C Claim Number.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1100 | 2200D
AMT - Claim Submitted Charges Amount
ActionModify Segment Situational Rule
Changed to "Required when the information receiver wants to further define data related to a specific claim. If not required by this implementation guide may be provided by the sender but cannot be required by the receiver."
CR 415Review the usage for Institutional Bill Type.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1100 | 2200D
AMT - Claim Submitted Charges Amount
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Payer Claim Control Number
ActionAdd Segment Note
See Section 1.4.8 for Payer Claim Control Number Search and Response requirements.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Payer Claim Control Number
ActionModify Segment Situational Rule
Changed To:
Required when a claim is located in the Information Source's system or when a payer claim control number was submitted on the 276, but did not result in a found claim for the submitted number. If not required by this implementation guide, do not send.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Institutional Bill Type Identification
ActionModify Segment Situational Rule
Changed to "Required when an institutional claim is located in the Information Source's system. If not required by this implementation guide, do not send."
CR 415Review the usage for Institutional Bill Type.
LocationX267 | Health Care Claim Status Request and Response
TRN - Provider of Service Trace Identifier
ActionDelete Segment
PROVIDER OF SERVICE TRACE IDENTIFIER
CR 398Add guidance for how to link Claim Status Reject Responses back to the submitted claims.  
LocationX267 | Health Care Claim Status Request and Response
STC - Provider Status Information
ActionDelete Segment
PROVIDER STATUS INFORMATION
CR 398Add guidance for how to link Claim Status Reject Responses back to the submitted claims.  
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Provider's Assigned Claim Identifier
ActionModify Segment Name
From:
Patient control number

To:
Provider's Assigned Claim Identifier
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Provider's Assigned Claim Identifier
ActionModify Segment Situational Rule
Required when the Provider's Assigned Claim Identifier was submitted on the claim(s) found in the information source's system or if no claims are located, the value from the 276 request is returned. If not required by this implementation guide, do not send.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Provider's Assigned Claim Identifier
ActionModify Data Element Code Value
X1 - Provider Claim Number
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Provider's Assigned Claim Identifier
ActionAdd Data Element Note
REF02
This is the value from CLM01 of the 837.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Provider's Assigned Claim Identifier
ActionAdd Data Element Note
REF02
The maximum number of characters to be supported for this qualifier is 35. Characters beyond the maximum are not required to be stored or returned by the receiving system.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200D
REF - Property & Casualty Claim Number
ActionAdd Segment
277
Loop ID 2200D
REF - Property & Casualty Claim Number
CR 385Support the Property and Casualty industry need for a P&C Claim Number.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1200 | 2200D
DTP - Service Date
ActionModify Segment Note
Update Segment Note:
For Institutional claims, it is the statement period in loop 2300 (DTP01=434). For Professional claims this information is derived from the earliest service level dates in loop 2400 (DTP01=472) to the latest service level date. For Dental claims it is the service date at the claim loop 2300 (DTP01=472) or when not reported at Loop 2300, it is derived from the earliest service level date in loop 2400 (DTP01=472) to the latest service level date.
CR 383Change the usage requirement for the Claim Level Claim Date of Service DTP to situational to support predeterminations.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1200 | 2200D
DTP - Service Date
ActionModify Segment Situational Rule
Update Situational Rule to:
Required when the claim is not a predetermination and service level dates are not reported. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver.
CR 383Change the usage requirement for the Claim Level Claim Date of Service DTP to situational to support predeterminations.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1200 | 2200D
DTP - Service Date
ActionModify Data Element Code Note
RD8 (Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD)

Changed to:
Use when the "From and To" dates are different. However, at the discretion of the submitter, RD8 can also be used when the "From and To" dates are the same.
CR 1558Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1200 | 2200D
DTP - Service Date
ActionModify Segment Note
Update Segment Note:
For Institutional claims, it is the statement period in loop 2300 (DTP01=434). For Professional claims this information is derived from the earliest service level dates in loop 2400 (DTP01=472) to the latest service level date. For Dental claims it is the service date at the claim loop 2300 (DTP01=472) or when not reported at Loop 2300, it is derived from the earliest service level date in loop 2400 (DTP01=472) to the latest service level date.
CR 383Change the usage requirement for the Claim Level Claim Date of Service DTP to situational to support predeterminations.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1200 | 2200D
DTP - Service Date
ActionModify Segment Situational Rule
Update Situational Rule to:
Required when the claim is not a predetermination and service level dates are not reported. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver.
CR 383Change the usage requirement for the Claim Level Claim Date of Service DTP to situational to support predeterminations.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1200 | 2200D
DTP - Claim Received Date
ActionAdd Segment
277
Loop ID 2200D
DTP - Claim Received Date
CR 399Add Claim Received Date to support the timely filing requirements of states and payer contracts.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1300 | 2210D
SVC - Service Line Information
ActionDelete Data Element Code Value
Loop ID 2210D/SVC01-01

WK - Advanced Billing Concepts (ABC) Codes
CR 749Remove support for Advanced Billing Concept Codes (ABC) across the TR3s as HHS has discontinued the associated pilot project.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1300 | 2210D
SVC - Service Line Information
ActionAdd Data Element Note
Loop 2210D Service Line Information/SVC07 Units of Service Count

"The maximum length for this field is 8 digits excluding the decimal. When a decimal is used, the maximum number of digits allowed to the right of the decimal is three. A zero or negative value is not allowed."
CR 1410Negative values are being submitted in the Claim Status Amount and Service Unit data elements of the Claim Status transactions where they do not make business sense. Such negative values should be disallowed.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1300 | 2210D
SVC - Service Line Information
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1300 | 2210D
SVC - Service Line Information
ActionModify Data Element Code Note
HC (Healthcare Common Procedure Coding System (HCPCS) Codes)

Changed to:
Use when reporting HCPCS or CPT codes. AMA's CPT codes are level 1 HCPCS codes, they are reported with an HC qualifier.
CR 1542Improve the consistency of the code value notes within and across the TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1400 | 2210D
REF - Line Item Control Number
ActionModify Data Element Code Value
REF01
Replaced code value FJ with 6R - Provider Control Number.
CR 1562For consistency across all guides
LocationX329 | Health Care Claim Status Request and Response | 276 | 1400 | 2210D
REF - Line Item Control Number
ActionModify Segment Situational Rule
Changed to "Required when submitted on the 837 and sending a request for status at the line level. If not required by this implementation guide, do not send."
CR 4132210D/E REF*6R 276: Clarify intention for searching.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1400 | 2210D
REF - Line Item Control Number
ActionModify Segment Name
From: Service Line Item Identification

Changed to:
Line Item Control Number
CR 1539Modify the 2000A REF segment situational rule and the segment name in 275, 276 and 277 guides.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1500 | 2210D
DTP - Service Date
ActionAdd Segment Situational Rule
Required when a service level date was submitted on the claim for this service. If not required by this implementation guide, do not send.
CR 395The Service Line Date of Service is always required, however institutional lines can be reported without a date of service.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1500 | 2210D
DTP - Service Date
ActionModify Segment Usage
Changed from Required to Situational
CR 395The Service Line Date of Service is always required, however institutional lines can be reported without a date of service.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1500 | 2210D
DTP - Service Date
ActionModify Data Element Code Note
RD8 (Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD)

Changed to:
Use when the "From and To" dates are different. However, at the discretion of the submitter, RD8 can also be used when the "From and To" dates are the same.
CR 1558Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1550 | 2210D
TOO - Tooth Information
ActionAdd Segment
276
Loop ID 2210D
TOO - TOOTH INFORMATION
CR 1516For consistency across guides.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220D
SVC - Service Line Information
ActionModify Segment Situational Rule
Changed to "Required when service line level status varies by service line or is different than the claim-level status. If not required by this implementation guide, may be provided at the sender's discretion but can not be required by the receiver."
CR 405Strengthen the verbiage in Section 1.4.2.2 to require the return of service line details.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220D
SVC - Service Line Information
ActionDelete Data Element Code Value
Loop ID 2220D/SVC01-01

WK - Advanced Billing Concepts (ABC) Codes
CR 749Remove support for Advanced Billing Concept Codes (ABC) across the TR3s as HHS has discontinued the associated pilot project.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220D
SVC - Service Line Information
ActionAdd Data Element Note
Loop ID 2220D Service Line Information/SVC07 Units of Service Count
"The maximum length for this field is 8 digits excluding the decimal. When a decimal is used, the maximum number of digits allowed to the right of the decimal is three. A zero or negative value is not allowed."
CR 1410Negative values are being submitted in the Claim Status Amount and Service Unit data elements of the Claim Status transactions where they do not make business sense. Such negative values should be disallowed.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220D
SVC - Service Line Information
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220D
SVC - Service Line Information
ActionModify Data Element Code Note
HC (Healthcare Common Procedure Coding System (HCPCS) Codes)

Changed to:
Use when reporting HCPCS or CPT codes. AMA's CPT codes are level 1 HCPCS codes, they are reported with an HC qualifier.
CR 1542Improve the consistency of the code value notes within and across the TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionModify Data Element Situational Rule
STC01-03, STC10-03, STC11-03
Changed to "Required when an entity must be identified to further clarify the status code in this composite data element. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver."
CR 371Clarify when Claim Status Codes require the transmission of an Entity Code.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionModify Data Element Situational Rule
STC10 and STC11
Changed to "Required when additional status information is needed. If not required by this implementation guide, do not send."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionModify Data Element Code Value
STC01-03 (Entity Type Code)
Standardized (Added/Removed) Entity Type Codes in STC Segment at Claim and Service Levels.
CR 419STC: Standardize use of the same Entity Codes across the TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionModify Data Element Usage
STC06, STC08, STC09 Changed from Not Used to Situational
CR 4162220 D/E STC: Review business use to evaluate the need for line level payment information.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionAdd Data Element Code Value
O4 - Factor
CR 95The Property & Casualty industry needs the ability to report external entities who purchase accounts receivable assets on behalf of a payer (i.e. Factoring Agent).
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionAdd Data Element Code Value
OOP - Other Operating Physician
CR 952Replace the ZZ qualifier with an explicit qualifier that identifies Other Operating Physician.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionModify Data Element Note
STC08 Remittance Date

Changed to "This is the payment effective date from the remittance advice. In the 835, this is the value in BPR16."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionModify Data Element Note
STC09 Remittance Trace Number

Changed to "This is the unique identification number assigned to the payment in the remittance advice for tracking purposes. In the 835, this is the value from TRN02."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionAdd Data Element Situational Rule
STC06, STC08, STC09

Required when the remittance cycle is complete, this service is included on a payment that is reported in an 835 or paper remittance to the provider AND the payment information for this service is different from the claim level payment information. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver.
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionModify Data Element Note
STC06 Adjudication Finalized Date

Changed to "This is the date of approval or denial for the service. This date may or may not be the same as the payment effective date from the remittance advice (STC08). In the 835, the payment effective date is BPR16."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionAdd Data Element Code Value
AY - Clearinghouse
CR 1120Support reporting of a clearinghouse entity code in the claim status guides. Support reporting of a clearinghouse entity code in the claim status guides.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220D
STC - Service Line Status Information
ActionAdd Data Element
Loop ID 2220D / STC13 (Service Line Predetermination of Benefits Code)
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response | 277 | 2000 | 2220D
REF - Line Item Control Number
ActionModify Data Element Code Value
REF01
Replaced code value FJ with 6R - Provider Control Number.
CR 1562For consistency across all guides
LocationX329 | Health Care Claim Status Request and Response | 277 | 2000 | 2220D
REF - Line Item Control Number
ActionModify Segment Name
From: Service Line Item Identification

Changed to:
Line Item Control Number
CR 1539Modify the 2000A REF segment situational rule and the segment name in 275, 276 and 277 guides.
LocationX329 | Health Care Claim Status Request and Response | 277 | 2100 | 2220D
DTP - Service Date
ActionAdd Segment Situational Rule
Required when a service level date was submitted on the claim for this service. If not required by this implementation guide, do not send.
CR 395The Service Line Date of Service is always required, however institutional lines can be reported without a date of service.
LocationX329 | Health Care Claim Status Request and Response | 277 | 2100 | 2220D
DTP - Service Date
ActionModify Segment Usage
Changed from Required to Situational
CR 395The Service Line Date of Service is always required, however institutional lines can be reported without a date of service.
LocationX329 | Health Care Claim Status Request and Response | 277 | 2150 | 2220D
TOO - Tooth Information
ActionAdd Segment
277
Loop ID 2220D
TOO - TOOTH INFORMATION
CR 1516For consistency across guides.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000E
HL - Dependent Level
ActionModify Data Element Note
HL01 Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0100 | 2000E
HL - Dependent Level
ActionModify Segment Situational Rule
Required when Loop 2000D HL04 = 1. If not required by this implementation guide, do not send.
CR 1550Base the situational rule on the HL04 value, supporting non-subjective editing.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000E
HL - Dependent Level
ActionModify Data Element Note
HL01 Changed to "The first HL01 within each ST-SE envelope must begin with "1", and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01."
CR 1109For consistency, consider restricting HL01 to numeric values and requiring that enumeration of HL01 begin with 1 and be incremented by 1 for each iteration.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0100 | 2000E
HL - Dependent Level
ActionModify Segment Situational Rule
Required when Loop 2000D HL04 = 1. If not required by this implementation guide, do not send.
CR 1550Base the situational rule on the HL04 value, supporting non-subjective editing.
LocationX329 | Health Care Claim Status Request and Response | 276 | 0500 | 2100E
NM1 - Dependent Name
ActionModify Data Element Situational Rule
Changed to "Required when the person has a middle name or initial that is known. If not required by this implementation guide, do not send."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 0500 | 2100E
NM1 - Dependent Name
ActionModify Data Element Situational Rule
Changed to "Required when the person has a middle name or initial that is known. If not required by this implementation guide, do not send."
CR 1153To clarify intended use.
LocationX267 | Health Care Claim Status Request and Response
REF - Application or Location System Identifier
ActionDelete Segment
LOOP 2200E REF - APPLICATION OR LOCATION SYSTEM IDENTIFIER
CR 412HPID may make this obsolete. Unable to determine valid business needs for this proprietary routing data which causes provider reporting burdens.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Payer Claim Control Number
ActionAdd Segment Note
See Section 1.4.8 for Payer Claim Control Number Search and Response requirements.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionModify Data Element Situational Rule
STC01-03, STC10-03, STC11-03
Changed to "Required when an entity must be identified to further clarify the status code in this composite data element. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver."
CR 371Clarify when Claim Status Codes require the transmission of an Entity Code.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionModify Data Element Situational Rule
STC10 and STC11
Changed to "Required when additional status information is needed. If not required by this implementation guide, do not send."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionModify Data Element Code Value
STC01-03 (Entity Type Code)
Standardized (Added/Removed) Entity Type Codes in STC Segment at Claim and Service Levels.
CR 419STC: Standardize use of the same Entity Codes across the TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionAdd Data Element Code Value
O4 - Factor
CR 95The Property & Casualty industry needs the ability to report external entities who purchase accounts receivable assets on behalf of a payer (i.e. Factoring Agent).
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionAdd Data Element Code Value
OOP - Other Operating Physician
CR 952Replace the ZZ qualifier with an explicit qualifier that identifies Other Operating Physician.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionModify Data Element Note
STC06 Adjudication Finalized Date

Changed to "This is the date of denial or approval for the claim. This date may or may not be the same as the payment effective date from the remittance advice (STC08). In the 835, the payment effective date is BPR16."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionModify Data Element Situational Rule
STC08 Remittance Date
and
STC09 Remittance Trace Number

Changed to "Required when the remittance cycle is complete and this claim is included on a payment that is reported in an 835 or paper remittance to the provider. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionModify Data Element Note
STC08 Remittance Date

Changed to "This is the payment effective date from the remittance advice. In the 835, this is the value in BPR16."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionModify Data Element Note
STC09 Remittance Trace Number

Changed to "This is the unique identification number assigned to the payment in the remittance advice for tracking purposes. In the 835, this is the value from TRN02."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionAdd Data Element Code Value
AY - Clearinghouse
CR 1120Support reporting of a clearinghouse entity code in the claim status guides. Support reporting of a clearinghouse entity code in the claim status guides.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1000 | 2200E
STC - Claim Level Status Information
ActionAdd Data Element
Loop ID 2200E / STC13 (Predetermination of Benefits Code)
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Institutional Bill Type Identification
ActionModify Segment Situational Rule
Changed to "Required when the information receiver wants to further define data related to a specific claim. If not required by this implementation guide may be provided by the sender but cannot be required by the receiver."
CR 415Review the usage for Institutional Bill Type.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Provider's Assigned Claim Identifier
ActionModify Segment Name
From:
Patient control number

To:
Provider's Assigned Claim Identifier
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Provider's Assigned Claim Identifier
ActionModify Segment Situational Rule
Changed To:
Required when the Provider's Assigned Claim Identifier was submitted on the claim. If not required by this implementation guide, do not send.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Provider's Assigned Claim Identifier
ActionModify Data Element Code Value
X1 - Provider Claim Number
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Provider's Assigned Claim Identifier
ActionAdd Data Element Note
This is the value from CLM01 of the 837.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Provider's Assigned Claim Identifier
ActionAdd Data Element Note
The maximum number of characters to be supported for this qualifier is 35. Characters beyond the maximum are not required to be stored or returned by the receiving system.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Pharmacy Prescription Number
ActionModify Segment Situational Rule
Changed to "Required when the information receiver wants to further define data related to a specific claim. If not required by this implementation guide may be provided by the sender but cannot be required by the receiver."
CR 415Review the usage for Institutional Bill Type.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Claim Identifier For Transmission Intermediaries
ActionModify Segment Situational Rule
Changed To:
Required when a transmission intermediary (clearinghouse or other) needs to attach their own unique tracking number. If not required by this implementation guide, do not send.
CR 392Create a shared situational rule for REF*D9.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1000 | 2200E
REF - Property & Casualty Claim Number
ActionAdd Segment
276
Loop ID 2200E
REF - Property & Casualty Claim Number
CR 385Support the Property and Casualty industry need for a P&C Claim Number.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1100 | 2200E
AMT - Claim Submitted Charges Amount
ActionModify Segment Situational Rule
Changed to "Required when the information receiver wants to further define data related to a specific claim. If not required by this implementation guide may be provided by the sender but cannot be required by the receiver."
CR 415Review the usage for Institutional Bill Type.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1100 | 2200E
AMT - Claim Submitted Charges Amount
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Payer Claim Control Number
ActionAdd Segment Note
See Section 1.4.8 for Payer Claim Control Number Search and Response requirements.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Payer Claim Control Number
ActionModify Segment Situational Rule
Changed To:
Required when a claim is located in the Information Source's system or when a payer claim control number was submitted on the 276, but did not result in a found claim for the submitted number. If not required by this implementation guide, do not send.
CR 418Establish request and response consistency by developing a standard search criteria and response.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Institutional Bill Type Identification
ActionModify Segment Situational Rule
Changed to "Required when an institutional claim is located in the Information Source's system. If not required by this implementation guide, do not send."
CR 415Review the usage for Institutional Bill Type.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Provider's Assigned Claim Identifier
ActionModify Segment Name
From:
Patient control number

To:
Provider's Assigned Claim Identifier
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Provider's Assigned Claim Identifier
ActionModify Segment Situational Rule
Required when the Provider's Assigned Claim Identifier was submitted on the claim(s) found in the information source's system or if no claims are located, the value from the 276 request is returned. If not required by this implementation guide, do not send.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Provider's Assigned Claim Identifier
ActionModify Data Element Code Value
X1 - Provider Claim Number
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Provider's Assigned Claim Identifier
ActionAdd Data Element Note
This is the value from CLM01 of the 837.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Provider's Assigned Claim Identifier
ActionAdd Data Element Note
The maximum number of characters to be supported for this qualifier is 35. Characters beyond the maximum are not required to be stored or returned by the receiving system.
CR 1119Clearly differentiate between Patient Account Number and the Provider Assigned Claim Identifier in the 276 and 277 TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1100 | 2200E
REF - Property & Casualty Claim Number
ActionAdd Segment
277
Loop ID 2200E
REF - Property & Casualty Claim Number
CR 385Support the Property and Casualty industry need for a P&C Claim Number.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1200 | 2200E
DTP - Service Date
ActionModify Segment Note
Update Segment Note:
For Institutional claims, it is the statement period in loop 2300 (DTP01=434). For Professional claims this information is derived from the earliest service level dates in loop 2400 (DTP01=472) to the latest service level date. For Dental claims it is the service date at the claim loop 2300 (DTP01=472) or when not reported at Loop 2300, it is derived from the earliest service level date in loop 2400 (DTP01=472) to the latest service level date.
CR 383Change the usage requirement for the Claim Level Claim Date of Service DTP to situational to support predeterminations.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1200 | 2200E
DTP - Service Date
ActionModify Segment Situational Rule
Update Situational Rule to:
Required when the claim is not a predetermination and service level dates are not reported. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver.
CR 383Change the usage requirement for the Claim Level Claim Date of Service DTP to situational to support predeterminations.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1200 | 2200E
DTP - Service Date
ActionModify Data Element Code Note
RD8 (Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD)

Changed to:
Use when the "From and To" dates are different. However, at the discretion of the submitter, RD8 can also be used when the "From and To" dates are the same.
CR 1558Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1200 | 2200E
DTP - Service Date
ActionModify Segment Note
Update Segment Note:
For Institutional claims, it is the statement period in loop 2300 (DTP01=434). For Professional claims this information is derived from the earliest service level dates in loop 2400 (DTP01=472) to the latest service level date. For Dental claims it is the service date at the claim loop 2300 (DTP01=472) or when not reported at Loop 2300, it is derived from the earliest service level date in loop 2400 (DTP01=472) to the latest service level date.
CR 383Change the usage requirement for the Claim Level Claim Date of Service DTP to situational to support predeterminations.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1200 | 2200E
DTP - Service Date
ActionModify Segment Situational Rule
Update Situational Rule to:
Required when the claim is not a predetermination and service level dates are not reported. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver.
CR 383Change the usage requirement for the Claim Level Claim Date of Service DTP to situational to support predeterminations.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1200 | 2200E
DTP - Claim Received Date
ActionAdd Segment
277
Loop ID 2200E
DTP - Claim Received Date
CR 399Add Claim Received Date to support the timely filing requirements of states and payer contracts.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1300 | 2210E
SVC - Service Line Information
ActionDelete Data Element Code Value
Loop ID 2210E/SVC01-01

WK - Advanced Billing Concepts (ABC) Codes
CR 749Remove support for Advanced Billing Concept Codes (ABC) across the TR3s as HHS has discontinued the associated pilot project.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1300 | 2210E
SVC - Service Line Information
ActionAdd Data Element Note
SVC07 Units of Service Count
The maximum length for this field is 8 digits excluding the decimal. When a decimal is used, the maximum number of digits allowed to the right of the decimal is three. A zero or negative value is not allowed.
CR 1410Negative values are being submitted in the Claim Status Amount and Service Unit data elements of the Claim Status transactions where they do not make business sense. Such negative values should be disallowed.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1300 | 2210E
SVC - Service Line Information
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1300 | 2210E
SVC - Service Line Information
ActionModify Data Element Code Note
HC (Healthcare Common Procedure Coding System (HCPCS) Codes)

Changed to:
Use when reporting HCPCS or CPT codes. AMA's CPT codes are level 1 HCPCS codes, they are reported with an HC qualifier.
CR 1542Improve the consistency of the code value notes within and across the TR3s.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1400 | 2210E
REF - Line Item Control Number
ActionModify Data Element Code Value
REF01
Replaced code value FJ with 6R - Provider Control Number.
CR 1562For consistency across all guides
LocationX329 | Health Care Claim Status Request and Response | 276 | 1400 | 2210E
REF - Line Item Control Number
ActionModify Segment Situational Rule
Changed to "Required when submitted on the 837 and sending a request for status at the line level. If not required by this implementation guide, do not send."
CR 4132210D/E REF*6R 276: Clarify intention for searching.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1400 | 2210E
REF - Line Item Control Number
ActionModify Segment Name
From: Service Line Item Identification

Changed to:
Line Item Control Number
CR 1539Modify the 2000A REF segment situational rule and the segment name in 275, 276 and 277 guides.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1500 | 2210E
DTP - Service Date
ActionAdd Segment Situational Rule
Required when a service level date was submitted on the claim for this service. If not required by this implementation guide, do not send.
CR 395The Service Line Date of Service is always required, however institutional lines can be reported without a date of service.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1500 | 2210E
DTP - Service Date
ActionModify Segment Usage
Changed from Required to Situational
CR 395The Service Line Date of Service is always required, however institutional lines can be reported without a date of service.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1500 | 2210E
DTP - Service Date
ActionModify Data Element Code Note
RD8 (Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD)

Changed to:
Use when the "From and To" dates are different. However, at the discretion of the submitter, RD8 can also be used when the "From and To" dates are the same.
CR 1558Format code notes consistently.
LocationX329 | Health Care Claim Status Request and Response | 276 | 1550 | 2210E
TOO - Tooth Information
ActionAdd Segment
276
Loop ID 2210E
TOO - TOOTH INFORMATION
CR 1516For consistency across guides.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220E
SVC - Service Line Information
ActionModify Segment Situational Rule
Changed to "Required when service line level status varies by service line or is different than the claim-level status. If not required by this implementation guide, may be provided at the sender's discretion but can not be required by the receiver."
CR 405Strengthen the verbiage in Section 1.4.2.2 to require the return of service line details.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220E
SVC - Service Line Information
ActionDelete Data Element Code Value
Loop ID 2220E/SVC01-01

WK - Advanced Billing Concepts (ABC) Codes
CR 749Remove support for Advanced Billing Concept Codes (ABC) across the TR3s as HHS has discontinued the associated pilot project.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220E
SVC - Service Line Information
ActionAdd Data Element Note
SVC07 Units of Service Count
The maximum length for this field is 8 digits excluding the decimal. When a decimal is used, the maximum number of digits allowed to the right of the decimal is three. A zero or negative value is not allowed.
CR 1410Negative values are being submitted in the Claim Status Amount and Service Unit data elements of the Claim Status transactions where they do not make business sense. Such negative values should be disallowed.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220E
SVC - Service Line Information
ActionAdd Data Element Note
to DE 782 (Monetary Amount):

The maximum length of this instance of data element 782 is 10.
CR 1013Add a consistent element note explaining the maximum length to every monetary amount element.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1800 | 2220E
SVC - Service Line Information
ActionModify Data Element Code Note
HC (Healthcare Common Procedure Coding System (HCPCS) Codes)

Changed to:
Use when reporting HCPCS or CPT codes. AMA's CPT codes are level 1 HCPCS codes, they are reported with an HC qualifier.
CR 1542Improve the consistency of the code value notes within and across the TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionModify Data Element Situational Rule
STC01-03, STC10-03, STC11-03
Changed to "Required when an entity must be identified to further clarify the status code in this composite data element. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver."
CR 371Clarify when Claim Status Codes require the transmission of an Entity Code.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionModify Data Element Situational Rule
STC10 and STC11
Changed to "Required when additional status information is needed. If not required by this implementation guide, do not send."
CR 1153To clarify intended use.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionModify Data Element Code Value
STC01-03 (Entity Type Code)
Standardized (Added/Removed) Entity Type Codes in STC Segment at Claim and Service Levels.
CR 419STC: Standardize use of the same Entity Codes across the TR3s.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionModify Data Element Usage
STC06, STC08, STC09 Changed from Not Used to Situational
CR 4162220 D/E STC: Review business use to evaluate the need for line level payment information.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionAdd Data Element Code Value
O4 - Factor
CR 95The Property & Casualty industry needs the ability to report external entities who purchase accounts receivable assets on behalf of a payer (i.e. Factoring Agent).
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionAdd Data Element Code Value
OOP - Other Operating Physician
CR 952Replace the ZZ qualifier with an explicit qualifier that identifies Other Operating Physician.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionModify Data Element Note
STC08 Remittance Date

Changed to "This is the payment effective date from the remittance advice. In the 835, this is the value in BPR16."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionModify Data Element Note
STC09 Remittance Trace Number

Changed to "This is the unique identification number assigned to the payment in the remittance advice for tracking purposes. In the 835, this is the value from TRN02."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionAdd Data Element Situational Rule
STC06, STC08, STC09

Required when the remittance cycle is complete, this service is included on a payment that is reported in an 835 or paper remittance to the provider AND the payment information for this service is different from the claim level payment information. If not required by this implementation guide, may be provided at the sender's discretion but cannot be required by the receiver.
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionModify Data Element Note
STC06 Adjudication Finalized Date

Changed to "This is the date of approval or denial for the service. This date may or may not be the same as the payment effective date from the remittance advice (STC08). In the 835, the payment effective date is BPR16."
CR 1265Allow for card payments (p-card, debit card, and credit card) within the 835 and related X12 transactions so remittance information can be conveyed electronically in these scenarios.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionAdd Data Element Code Value
AY - Clearinghouse
CR 1120Support reporting of a clearinghouse entity code in the claim status guides. Support reporting of a clearinghouse entity code in the claim status guides.
LocationX329 | Health Care Claim Status Request and Response | 277 | 1900 | 2220E
STC - Service Line Status Information
ActionAdd Data Element
Loop ID 2220E / STC13 (Service Line Predetermination of Benefits Code)
CR 1192Create a definitive method for identifying status requests and responses for pre-determination of benefit claims.
LocationX329 | Health Care Claim Status Request and Response | 277 | 2000 | 2220E
REF - Line Item Control Number
ActionModify Data Element Code Value
REF01
Replaced code value FJ with 6R - Provider Control Number.
CR 1562For consistency across all guides
LocationX329 | Health Care Claim Status Request and Response | 277 | 2000 | 2220E
REF - Line Item Control Number
ActionModify Segment Name
From: Service Line Item Identification

Changed to:
Line Item Control Number
CR 1539Modify the 2000A REF segment situational rule and the segment name in 275, 276 and 277 guides.
LocationX329 | Health Care Claim Status Request and Response | 277 | 2100 | 2220E
DTP - Service Date
ActionAdd Segment Situational Rule
Required when a service level date was submitted on the claim for this service. If not required by this implementation guide, do not send.
CR 395The Service Line Date of Service is always required, however institutional lines can be reported without a date of service.
LocationX329 | Health Care Claim Status Request and Response | 277 | 2100 | 2220E
DTP - Service Date
ActionModify Segment Usage
Changed from Required to Situational
CR 395The Service Line Date of Service is always required, however institutional lines can be reported without a date of service.
LocationX329 | Health Care Claim Status Request and Response | 277 | 2150 | 2220E
TOO - Tooth Information
ActionAdd Segment
277
Loop ID 2220E
TOO - TOOTH INFORMATION
CR 1516For consistency across guides.
LocationX267 | Health Care Claim Status Request and Response
REF - Application or Location System Identifier
ActionDelete Segment
LOOP 2200E REF - APPLICATION OR LOCATION SYSTEM IDENTIFIER
CR 412HPID may make this obsolete. Unable to determine valid business needs for this proprietary routing data which causes provider reporting burdens.