We have a trading partner who indicates the reject is incorrect and based on the TR3, that this is a recommendation for those on 5010A1 to be more efficient – NOT a requirement and that we should accept:
EQ*88
EQ*90
And
EQ*88^90 (repetition being the ^ char)
And
EQ*30
In addition to the 270/271 TR3 notes, X12.6, Application Control Structure: 3.8.3.1 Repeated Occurrences of Single Data Segments
When a single data segment is allowed to be repeated, it may have a specified maximum number of occurrences defined at each specified position within a given transaction set standard. Alternatively, a segment may be allowed to repeat an unlimited number of times.
Should the use of only the repetition separator to be used or should we allow the use for both situations?
Standard Interpretation:
Either representation of expressing the value of EQ01 is acceptable according to the standard. The standard expresses no preference.
An implementation guide may mandate one representation or another.
Implementation Guide Interpretation:
The 005010X279 TR3 270 2110C EQ segment contains the following TR3 note 5:
“EQ01 is a repeating data element that may be repeated up to 99 times. If all of the information that will be used in the 2110C loop is the same with the exception of the Service Type Code used in EQ01, it is more efficient to use the repetition function of EQ01 to send each of the Service Type Codes needed. If an Information Source supports more than Service Type Code “30", and can support requests for multiple Service Type Codes, the repetition use of EQ01 must be supported.” A similar TR3 note is contained in the 2110D EQ segment.
Information Sources (typically health plans) are not required by the 005010X279 TR3 to support multiple service type code inquiries, however if an Information Source does support multiple service type code inquiries, they are required by the TR3 to support receiving those multiple service type codes in both a repeating element and in multiple 2110 EQ segments and as such, would need to support receiving any combination of multiple EQ segments and repeating elements.
Information Receivers (typically health care providers) are not required by the 005010X279 TR3 to send multiple service type codes in a 270 inquiry, and if they choose to send multiple service type codes, they may choose whether to use the repetition function of EQ01 and/or send multiple 2110 EQ segments or both.
The 005010X279 TR3 explicitly limits the maximum repetitions of data element 1365 within EQ01 to 99 as indicated under the attributes.
Further Discussion
If an Information Source does not support inquiries for multiple service type codes the 005010X279 TR3 does not specify what action the Information Source should take, however the best industry practice is to process the first EQ segment and first repeat of EQ01 service type code and ignore any remaining occurrences of repetitions or EQ segments.