We have a clearinghouse sending us Health Care Claim Status Category Codes in the STC01-1 element in the 277CA transaction that are not 'A' and 'E' codes. Can you please clarify if Health Care Claim Status Category Codes that start with 'F', 'P' or 'R' can be sent in the 005010X214 transaction STC01-1 element in the 2200B or 2200D loops?
This issue is explicitly addressed in guide 005010X214. The STC01-1 element note in loops 2200B and 2200D reads:
“For this business application acknowledgment, use of the Claim Status Category Code is limited to category types ‘A’ for batch. For real time acknowledgements category types ‘A’ and ‘E’ may be used except for E0. Use of the category type ‘E’ is limited to indicating the business application system is unavailable.”
Use of category codes ‘F’, ‘P’, and ‘R’ in the STC01-1 for loops 2200B and 2200D is not compliant with the TR3.
To review X12's position on the action to take in regard to the recept of non-compliant transactions, please see RFI 1512