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Flat File Changes in the Health
Care Claim Professional (837 Professional) Version
4010A1, Health Care Claim Payment/Advice (835) Version
4010, 4010A1 and 3051.4A, and Health Care Claim Status
Inquiry and Response (276/277) Version 4010A1
Transactions
The following are the shared systems updates to the
X12N based flat files for 837 Professional, 835 and
276/277 transactions.
Professional (Carrier) 837
X12N-Based Flat File
The X12N-based flat file has been updated to reflect
the following:
The COBOL picture 9(7)V999 for data elements SV104 in
loop 2400 and CTP04 in loop 2410 was added in order to
capture the metric units quantity (CTP05-1 =
“F2” international units).
The REF segment was changed on the flat file to
include the new values for A1. The new values for 4010A1
are “004010X098DA1” and
“004010X098A1.”
- The COBOL picture, 9(2)V9, for data element MEA03
in loop 2400 applies to qualifiers R1, R2 and R4.
The X12N-based flat file is in an Excel spreadsheet
format. The updated file can be downloaded from the
following Web site: http://www.cms.hhs.gov/providers/edi/hipaadoc.asp.
The name of the file is P4010A1-2.zip. The revised
X12N-based flat file is the version to be used for the
October 1, 2003 release.
Carrier/DMERC 835 Version
4010 and 4010A1 Flat File Update
The flat file has been changed to accommodate quantity
in metric units, which may have up to 7 numeric
positions, and up to 3 decimal points. The updated flat
file is posted at http://www.cms.hhs.gov/providers/edi/hipaadoc.asp
under the file name B835v4010&4010A1-2.zip.
The following fields have been changed in the updated
flat file:
SVC05 Units of Service Paid Count PIC changed from
S9(3)V99 to S9(7)V999 if SVC01-1=N4
SVC07 Original Units of Service Count PIC changed from
S9(7)V99 to S9(7)V999 if SVC01-1=N4
Carrier 276/277 X12N-Based
Flat File Update
The X12N-based flat file has been updated to reflect
the following:
The COBOL picture S9(7)V999 has been added to
accommodate the metric units for the NDC in the
following fields: SVC07 in the 2210D and 2210E Loops
for the 276; SVC07 in the 2220D and 2220E Loops for the
277, when the qualifier in SVC01-1 is N-4 (National
Drug Code in 5-4-2 format).
The flat file will be posted at http://www.cms.hhs.gov/providers/edi/hipaadoc.asp
under the file name 276277B-a1mar03.zip.
Reference: Change Request 2657, Transmittal
AB-03-060
Posted: 07/10/2003
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