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July 15, 2015

July 2015 HIPAA EDI Front End Edit Changes

Professional Edit Change Log

Edit Reference  Change
X222.490.2430.DTP03.030  The other insurance payment date at line level cannot be a future date.
X222.295.2320.SBR05.010 Deactivated 999 edit
X222.295.2320.SBR05.020 Added 999 R edit to validate valid values

Institutional Edit Change Log

Edit Reference  Change 
X223.294.2300.HI01-2.030 Added new 277CA edit, to reject claims with Internal Payer Use only Condition codes 12-16, 62-65, M0-MZ, or UU.
X223.271.2300.HI01.2.030 Added new 277CA edit, to reject claims with Internal Payer Use only Occurrence codes 23, 48 or 49.
X223.258.2300.HI01-2.030 Added new 277CA edit, to reject claims with Internal Payer User only Occurrence Span code 79.
X223.284.2300.HI01-2.030 Added new 277CA edit, to reject claims with Internal Payer User only Value code 62-65, 70-79, Q0-Q9.
X223.423.2400..010  Revised edit to allow for up to 999 service lines
N/A The flat file layout has been updated to allow for up to 999 service lines

276/277 Edit Change Log

Edit Reference Change
X212.63/151.2200D.REF02.020 Changed the maximum number of characters to be 20, instead of 50.
X212.49/126.2100C.NM109.040 Note changed to remove translator Responsibility for Part A. This edit is accomplished in the CEM for both Parts A and B.
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