The following are the error types linked to specific 997 output that compliance maps capture. Since you can add error checking for your own business rules, this is not an exhaustive list.
For more information, see the chapter, “Working with Rules,” in the ECMap User’s Guide.
This section lists the description, cause, and action to take regarding the 2029 compliance map error.
Description: Segment exceeding maximum occurrence.
Cause: Violation of the gray box rules as described in the HIPAA Implementation Guide.
Action: Change incoming data or instruct the submitter of the data to provide a value in the field.
Map |
Example of text error messages for error code 2029 |
|---|---|
270 |
Not applicable |
271 |
Not applicable |
276 |
Received more than one REF segment (REF01=1K) in the loop Received more than one REF segment (REF01=BLT) in the loop Received more than one REF segment in loop 2200D where REF01 The maximum number of REF segments in loop 2200D has been exceeded |
277 |
The maximum number of REF segments in loop 2200D has been exceeded |
278RQ |
Not applicable |
278RP |
Not applicable |
820 |
Not applicable |
834 |
Not applicable |
835 |
2100-REF, Exceeds 10 Occur 2100-REF, Exceeds 5 Occurrence 2100-NM101=PR, Exceeds 2 Occur 2110-REF Exceeds 10 Occur 2110-REF Exceeds 7 Occur |
837D |
2320 SBR Loop count exceeds 10 2300 CLM Loop count exceeds 100 2400 LX Loop count exceeds 50 2430 SVD Loop count exceeds 25 |
837I |
2010AA-1st REF OCCURS > 8 Time 2010AA-2nd REF OCCURS > 8 Time 2010CA-REF Occurs GT 5 Times 2300-More than 1 AMT01=C5 2300-More than 1 AMT01=F3 2300-More than 1 AMT01=F5 2300-More than 1 AMT01=MA 2300-More than 1 DTP01=096 2300-More than 1 DTP01=434 2300-More than 1 DTP01=435 2300-More than 1 HI0101=BK 2300-More than 1 HI0101=DR 2300-More than 1 HL0101=BPorBR 2300-More than 1 NTE Segment 2300-More than 1 REF01=4N 2300-More than 1 REF01=9A 2300-More than 1 REF01=9C 2300-More than 1 REF01=D9 2300-More than 1 REF01=DD 2300-More than 1 REF01=EA 2300-More than 1 REF01=F8 2300-More than 1 REF01=G4 2300-More than 1 REF01=LX 2300-More than 1 REF01=P4 2300-More than 10 NTE Segments 2300-More than 2 CRC01=77 Seg 2300-More than 2 HI0101=BE 2300-More than 2 HI0101=BG 2300-More than 2 HI0101=BH 2300-More than 2 HI0101=BI 2300-More than 2 HI0101=TC 2300-More than 2 HI0101-BOorBQ 2300-More than 2 REF01=9ForG1 2300-More than 3 CRC01=75 Seg 2300-More than 3 CRC01=76 Seg 2310-More than 1 NM101=71 2310-More than 1 NM101=72 2310-More than 1 NM101=73 2310-More than 1 NM101=FA 2330-AMT Occurs More Than Once 2330A-NM101=IL Occurs > 1 2330B: REF Occurs > 1 |
837I (continued) |
2330B:REF Occurs > 2 2330B-NM101=PR Occurs > 1 2330C NM101=QC Occurs > 1 2330D: NM1=71 Occurs > 1 2330E:NM101=72 Occurs > 1 2330F: NM101=73 Occurs > 1 2330H:NM101=FA Occurs > 1 2400 -DTP01=472 Occurs > 1 2400-AMT01=GT Occurs > 1 2400-AMT01=N8 Occurs > 1 2400-DTP01=866 Occurs > 1 2420-NM101=71 Occurs > 1 2420-NM101=72 Occurs > 1 2420-NM101=73 Occurs > 1 |
837P |
2300 DTP Seg Exceeds Max Occur 2300 REF Seg Exceeds Max Occur 2310A NM1 Seg Exceeds MaxOccur 2310ANM1 DN SegExceedsMaxOccur 2310ANM1 P3 SegExceedsMaxOccur 2310B NM1 Seg Exceeds MaxOccur 2310C NM1 Seg Exceeds MaxOccur 2310D NM1 Seg Exceeds MaxOccur 2310E NM1 Seg Exceeds MaxOccur 2320 AMT Seg Exceeds Max Occur 2330 NM1 Seg Exceeds Max Occur 2330B REF Seg Exceeds MaxOccur 2330D NM1 DN SegExceedsMaxOccur 2400 AMT Seg Exceeds Max Occur 2400 CRC Seg Exceeds Max Occur 2400 DTP Seg Exceeds Max Occur 2400 REF Seg Exceeds Max Occur |
This section lists the description, cause, and action to take regarding the 2045 compliance map error.
Description: Invalid date and time field format.
Cause: Date in the data file does not match the format specified in the compliance map.
Action: Change incoming data to meet specified format.
Map |
Example of text error messages for error code 2045 |
|---|---|
270 |
DTP03 Length NE 17, RD8 Length DTP03 Length NE 17, Invalid RD8 DTP03 Length NE 8, Invalid D8 DTP03 NE 17, Invalid RD8 DTP03 NE 8, Invalid D8 Invalid D8 - Date Length Invalid DTP03 Length, DTP02=D8 Invalid RD8 - Date length to_date < from_date ! allowed |
271 |
DTP03 length ne 17 DTP03 length ne 8 To_date < from_date ! Allowed |
276 |
Date form does not = YYYYMMDD Invalid date range RD8 Length checked failed |
277 |
Date form does not = YYYYMMDD Incorrect date range Invalid date range |
278RQ |
2000F CR604 Date format wrong 2000F CR616 Date format wrong 2000F DTP/435 format incorrect 2000F DTP/472 format incorrect 2000F HI0104 Date format wrong 2000F HI0204 Date format wrong 2000F HI0304 Date format wrong 2000F HI0404 Date format wrong 2000F HI0504 Date format wrong 2000F HI0604 Date format wrong 2000F HI0704 Date format wrong 2000F HI0804 Date format wrong 2000F HI0904 Date format wrong 2000F HI1004 Date format wrong 2000F HI1104 Date format wrong 2000F HI1204 Date format wrong |
278RP |
To_date < from_date Incorrect length for D8 Incorrect length for RD8 Invalid D8 format |
820 |
Date Format must be YYYYMMDD Invalid length for date range To_date < from_date ! allowed |
834 |
Not applicable |
835 |
Not applicable |
837D |
2300-Invalid TM where DTP02=DT DTP 434 Stmt Dates required |
837I |
2300:DTP01=472 Invalid Date 2300-Invalid TM where DTP02=DT DTP 434 Stmt Dates required |
837P |
2300 - Invalid Time Format 2400 DTP03 is wrong length To Date cannot be less than From Date Wrong length Wrong tm: HH Wrong tm: MM |
This section lists the description, cause, and action to take regarding the 2169 compliance map error.
Description: Empty value mapped to EDI mandatory field.
Cause: Information on a required element within a segment is missing in the inbound data.
Action: Add element information in the specified location of the segment.
Map |
Example of text error messages for error code 2169 |
|---|---|
270 |
2100A_NM104 required if NM1=1 2100B_NM104 required if NM1=1 2100B_REF01=0B, REF03 required NM104 is invalid when 2100B level NM102 equals 2 NM105 is invalid when 2100B level NM102 equals 2 NM107 is invalid when 2100B level NM102 equals 2 |
271 |
PER02 absence mandates PER04 REF01 value mandates REF03 |
276 |
2100B_NM104 must be present 2100C_NM104 is required 2100D_NM104 is required |
277 |
Not applicable |
278RQ |
2010A - NM104 is blank 2010B - NM104 is blank |
278RP |
2000F HCR01=A1/HCR02 null 2000F HCR01=A3/HCR03 null 2000F HCR01=A4/HCR03 null 2000F HCR01=A6/HCR02 null 2010A-NM104 is blank 2010B-NM104 is blank |
820 |
04=ACH: 05-09,12-19 must exist |
834 |
INS01=Y, 08 must contain data NM102=1, 03/04 must have data |
835 |
Not applicable |
837D |
DMG in Loop 2320 is Missing DTP=330 Seg In 2300 is Missing DTP=435or 096 Seg 2300 Missing DTP=439 Accident Seg Missing DTP=441 Seg In 2400 is Missing If CLM11_1,2or3=AA, 04 is Req IF PWK02=EM,EL,BM,FX;05 is Req IF PWK02=EM,EL,BM,FX;06 is Req If SBR09=MB, CLM07 is required NM1 Segment in 2310C Missing NM104 is Required when NM102=1 NM108 is Required when NM102=1 NM109 is Required when NM102=1 REF Segment in 2310A Missing REF=F8 Segment in 2300 Missing SBR02=18, DMG in 2010BA is Req SBR02=18, N3 in 2010BA is Req SBR02=18, N4 in 2010BA is Req |
837I |
Not applicable |
837P |
Not applicable |
This section lists the description, cause, and action to take regarding the 2190 compliance map error.
Description: EDI Envelope data in error.
Cause: Information on a required element within an envelope segment is missing in the inbound data.
Action: Add element information in the specified location of the segment.
Map |
Example of text error messages for error code 2190 |
|---|---|
All Maps |
Invalid GS01 element Invalid GS08 element |
This section lists the description, cause, and action to take regarding the 2191 compliance map error.
Description: EDI envelope data in error.
Cause: Information on a required element within an envelope segment is missing in the inbound data.
Action: Add element information in the specified location of the segment.
Map |
Example of text error messages for error code 2191 |
|---|---|
All Maps |
Invalid ST01 element |
This section lists the description, cause, and action to take regarding the 2350 compliance map error.
Description: Invalid data in element.
Cause: Violation of gray box rules as described in the HIPAA Implementation Guide.
Action: Change incoming data or instruct the submitter of the data to provide a value in the field.
Map |
Example of text error messages for error code 2350 |
|---|---|
270 |
Not applicable |
271 |
2000A - Invalid HL01 value 2000B - Invalid HL01 value 2000B - Invalid HL02 value 2000C - Invalid HL01 value 2000C - Invalid HL02 value 2000D - Invalid HL01 value 2000D - Invalid HL02 value AAA03 must be 42 for AAA04 = R AAA03 must be 42 for AAA04 = Y EB01 val disallows REF01 val Invalid 2110C LE01 value, must be 2120 Invalid 2110D LE01 value, must be 2120 NM102 NE 1, NM104 disallowed NM102 NE 1, NM105 disallowed NM102 NE 1, NM107 disallowed PER02 empty, PER04 required PER03 mandates numeric PER04 PER05 mandates numeric PER06 PER07 mandates numeric PER08 TRN03 must start w/ 1, 3, or 9 |
276 |
2100B_NM102=2, check NM104/05 2210D_SVC04 not used SVC01=NU 2210E_SVC04 not used SVC01=NU HL has invalid value Phone # should be numeric |
277 |
2100B_NM102=2, check NM104/05 2100C_NM102=2, check NM104/04 2100C_NM102=2, check NM104/05 2220C_SVC04 not used SVC01=NU 2220E_SVC04 not used SVC0=NU Hl has invalid value Phone# length should be 10 Phone# should be numeric |
278RQ |
2000A HL01 count incorrect 2000B HL01 count incorrect 2000B HL02 count incorrect 2000C HL01 count incorrect 2000C HL02 count incorrect 2000C PWK05 & PWK06 must both be present or blank 2000C PWK05 is required when PWK02 is not 'AA' or 'VO' 2000C TRN03 is incorrect 2000D HL01 count incorrect 2000D HL02 count incorrect 2000D PWK05 & PWK06 must both be present or blank 2000D PWK05 is required when PWK02 is not 'AA' or 'VO' 2000D TRN03 is incorrect 2000E HL01 count incorrect 2000E HL02 count incorrect 2000F CR103 NE X, CR109 valued 2000F CR103=X, CR109 NULL 2000F CR106/CR107 not present 2000F CR106/CR108 not present 2000F CR201 valued/CR202 NULL 2000F CR205=MO/CR207 empty 2000F CR503/CR518 empty 2000F CR510/CR511 empty 2000F CR516 empty 2000F HL01 count incorrect 2000F HL02 count incorrect 2000F PWK05 & PWK06 must both be present or blank 2000F PWK05 is required when PWK02 is not 'AA' or 'VO' 2000F TRN03 is incorrect 2000F UM01=HS/CR208 empty 2000F UM01=HS/CR209 empty 2000F UM0503 not valued 2000F UM0503, UM0501/02 NULL 2000F UM06 empty when UM02=1 2010B PER02 NULL/PER03 NULL 2010B PER02 NULL/PER04 NULL 2010B NM102=2/NM105 NE NULL |
278RQ (continued) |
2010B NM102=2/NM107 NE NULL 2010B REF01=EI when NM108=24 2010B REF01=SY when NM108=34 2010C NM108=MI/REF01=1W 2010E PER02 NULL/ PER04 NULL 2010E PER02 NULL/PER03 NULL 2010E NM102=2/NM105 NE NULL 2010E NM102=2/NM107 NE NULL 2010E NM104 NULL/NM103 Present 2010E REF01=EI when NM108=24 2010E REF01=SY when NM108=34 |
278RP |
2000A HL01 count incorrect 2000B HL01 count incorrect 2000B HL02 count incorrect 2000C AAA01=N/ AAA03 null 2000C AAA03 present AAA04 null 2000C HL01 count incorrect 2000C HL02 count incorrect 2000C TRN03 is incorrect 2000D AAA01=N/ AAA03 null 2000D AAA01=N/ AAA04 null 2000D HL01 count incorrect 2000D HL02 count incorrect 2000D PWK05 & 06 must be present or blank 2000D PWK05 is required when PWK02 is not 'VO' 2000D TRN03 is incorrect 2000E HL01 count incorrect 2000E HL02 count incorrect 2000F AAA01=N/ AAA03 null 2000F AAA03 present AAA04 null 2000F CR205=MO/CR207 empty 2000F CR503/CR518 empty 2000F CR516 empty 2000F HL01 count incorrect 2000F HL02 count incorrect 2000F PWK05 & 06 must both be present or blank 2000F PWK05 is required when PWK02 is not 'VO' 2000F TRN03 is incorrect 2000F UM06 empty when UM02=12010A - PER03 is blank 2010A PER04 is blank 2010A AAA01=N/ AAA03 null |
278RP (continued) |
2010A AAA03 present AAA04 null 2010A NM102=2/NM105 NE NULL 2010A NM102=2/NM107 NE NULL 2010B AAA01=N/ AAA03 null 2010B AAA03 present AAA04 null 2010B REF01=EI when NM108=24 2010B REF01=SY when NM108=34 2010C AAA01=N/ AAA03 null 2010C AAA03 present AAA04 null 2010C NM108=MI/REF01=1W 2010CB N4 05 & 06 must both be present or blank 2010D AAA01=N/ AAA03 null 2010D AAA03 present AAA04 null 2010DB N4 05 & 06 must both be present or blank 2010E PER03 is blank 2010E PER04 is blank 2010E AAA01=N/ AAA03 null 2010E AAA03 present AAA04 null 2010E NM104 NULL/NM103 Present 2010E REF01=EI when NM108=24 2010E REF01=SY when NM108=34 phone# should be numeric |
820 |
BPR02 cannot be Negative BPR10 not precede by Value '1' Data not required Invalid phone number MaxLength in BPR02 exceeded MaxLength in REF02 exceeded Must be preceded by Value '1' TRN03 not equal BPR10 TRN04 not equal BPR11 |
834 |
2000 REF Member Identification Number out of sequence 2000 REF Member Policy Number out of sequence 2000 REF Prior Coverage Months out of sequence DMG04 contains data, INS01!=Y DMG05 contains data, INS01!=Y DMG06 contains data, INS01!=Y DSB08 Must equal 585 DTP01 = 349, HD01 = 024 HD05 not used if INS01 not=Y If BGN06 exist, BGN01 != 00 INS01 != Y, REF01 = 17 INS01 = Y, INS02 = 18 INS03 != 030 INS05 != C, INS07 = empty Mandatory 2000 REF Subscriber Number not first REF, or not N406 contains data, INS01 != Y NM103,4,5 in 2100A/B must EQ Phone# should be all digits REF01 contains data, INS01!=Y Req data INS06 not match 08 |
835 |
2103.NM105 may not be used 2103.NM107 may not be used 2103_NM104 may not be used 2104.NM104 may not be used 2104.NM105 may not be used 3200.CLP03 - CASall != CLP04 BPR04 != ACH, BPR05 disallowed H.3510 MIA or MOA, not both H.TRL sumCLP04 - sumPLB NE BPR HDR.BPR02 less than zero HDR.BPR02 more than 11 chars HDR.BPR04 must be NON HDR.BPR10 not preceeded by "1" HDR.TRN03 != BPR10 HDR.TRN03 not preceeded by "1" HDR.TRN04 != BPR11 MV_BPR_202MV_CLP04s - PLBamounts MV_CLP04sum MV_PLBsumamount phone# should be all numeric SVC not EQ CAS |
837D |
DTP in 2330B Segment is required when DTP in 2430 is missing HL01 not in right sequence HL02 in 2000B, Wrong Parent ID HL02 in 2000C, Wrong Parent ID If NM108=MI in 2010BA, REF!=1W If NM108=XX, REF01=EI,SY or TJ If NM108=XX, REF01=EI,SY or TJ Invalid Value in LX01 Invalid value in REF02 Header Length of CLM1 can't exceed 20 Loop ID 2310D: The value in element NM102 was equal to 1 but element NM104 was empty Loop ID 2420C: The value in element NM102 was equal to 1 but element NM104 was empty NM104 Should Be Empty NM105 Should Be Empty NM107 Should Be Empty NM109 2420B Must Match 2330B NM109 2420B Must Match SVD01 REF in 2330A is used only when SBR in 2320 is used REF02 Length can't exceed 20 SBR09=MB, REF01=SY is not a valid segment |
837I |
1000A_NM102 disallows NM105 1000A_NM102 val mandates NM104 1000A_PER04 is non-numeric 1000A_PER06 is non-numeric 1000A_PER08 is non-numeric 2000A Invalid HL01 value 2000B Invalid HL01 value 2000B Invalid HL02 value 2000B-SBR09 Empty 2000C Invalid HL01 value 2000C Invalid HL02 value 2010AA_PER04 is non-numeric 2010AA_PER06 is non-numeric 2010AA_PER08 is non-numeric 2010BA_NM102 disallows NM105 2010BA_NM104 required 2010BA_NM108 required 2010BA_NM109 is required 2010BA-NM102 Disallows NM107 2010BB_NM102 disallows NM105 2010BB_NM104 required 2010BB-NM102 disallows NM107 2010BD: NM102 disallows NM107 2010BD_NM102 disallows NM105 2010BD_NM104 is required 2010CA - pt. info missing2300 - Invalid Date Format 2300: Invalid RD8 Format2300: Invalid RD8 Format 2300 Missing Admitting Diag 2300 Warning CLM01>20 2300 CR616 Invalid Date 2300 CR616 Invalid Date Range 2300_CR604 Date Range Invalid 2300_CR604 Invalid Date Range 2300_PWK02 val mandates PWK05 2300_PWK02 val mandates PWK06 2300-Invalid Claim-No LX 2300-Invalid HHMM Format 2300-Invalid Time - Hour 2300-Invalid Time-Minute 2310A NM107 Contains Data |
837I (continued) |
2310A_NM102 disallows NM105 2310A_NM104 required 2310C NM107 Must Be Blank 2310C_NM102 disallows NM105 2310C_NM104 required 2320 SBR09 Empty 2330A NM107 Must Be Empty 2330A_NM102 disallows NM105 2330A_NM104 required 2400 Invalid value LX01 2400 SV206 Empty 2400_Invalid Date in DTP03 2400_PWK02 val mandates PWK05 2400_PWK02 val mandates PWK06 2420A NM107 Not Empty 2420A_NM102 disallows NM105 2420A_NM104 required 2420C Invalid entry in NM105 if NM102=Non Person 2420C Invalid entry in NM107 if NM102=Non Person 2420C Missing Mandatory NM104 when NM101=1 2420C NM107 Not Empty |
837P |
2000A Invalid Value in HL01 2000B HL04 should contain 1 2000B Invalid Value in HL01 2000B Invalid Value in HL0 2200B Medicare-SBR05 empty 2000C Invalid Value in HL01 2000C Invalid Value in HL0 2300 CLM10 Should contain data 2300 CLM1104 must contain data 2300 CR109 Required,CR103=X 2300 HI0102 contains a period 2300 HI0202 contains a period 2300 HI0302 contains a period 2300 HI0402 contains a period 2300 HI0502 contains a period 2300 HI0602 contains a period 2300 HI0702 contains a period 2300 HI0802 contains a period 2300 PWK05 Must Contain Data 2300 PWK06 Must Contain Data 2300 REF02 Len GT 20,REF01=D9 2320 OI04 Empty, Required CR109 Required, since CR103=X Loop 2300 EPSDT Referral - CRC LX01 Contains an Invalid Value Missing Mandatory DMG Segment - Loop 2320 Missing Mandatory DMG Segment - SBR02=18 Missing Mandatory N3 Segment - SBR02=18 Missing Mandatory N4 Segment - SBR02=18 More than 5000 Claims in Transactions N2 Segment should not be present, Length of NM103 NE 35 NM103 in Loop 2310D Cannot be Empty NM104 Should Not Be Empty NM105 Should Be Empty NM107 Should Be Empty NM108 Should Not Be Empty NM109 Should Not Be Empty PER04 contains non numeric data PER06 contains non numeric data PER08 contains non numeric data PRV in loop 2000A or 2310B should be present |
837P (continued) |
REF01=1W cannot be present when NM108=M1 REF01=1W cannot be present when NM108=M1 REF01=SY is invalid in loop 2310n SBR02 Must Equal 18 - HL04 = 0 SBR09=MB, REF01=SY is not a valid segment SV10701 must contain data since HI segment is present The data in CLM01 is greater than 20, some systems may truncate The value in loop 2420G NM109 was not equal to the value in loop 2330B NM109 The value in loop 2430 SVD01 was not equal to the value in loop 2330B NM109 When DTP01=439 present, CLM11 must contain data |
This section lists the description, cause, and action to take regarding the 2360 compliance map error.
Description: Invalid segment.
Cause: Violation of gray box rules as described in the HIPAA Implementation Guide.
Action: Change incoming data or instruct the submitter of the data to provide a value in the field.
Map |
Example of text error messages for error code 2360 |
|---|---|
270 |
Not applicable |
271 |
Not applicable |
276 |
Missing mandatory NM1 element No DTP segment was found in either the 2200D or 2210D Subscriber No DTP segment was found in either the 2200E or 2210E loops The 2200E REF segment, REF01=1K is invalid The subscriber is not the patient, but a DMG segment was present The subscriber is the patient, but no DMG segment was present |
277 |
2100B_NM102=1, NM104 is used 2100C NM104 required if NM1=1 2100D_NM104 required if NM1=1 A DMG segment was found in Loop 2000D when the subscriber was not the patient Missing NM1 for HL 03 = 23 Missing TRN for HL 03 = 23 No DMG segment found in Loop 2000D when subscriber is the patient Received more than one REF segment (REF01=1K) in the loop Received more than one REF segment (REF01=BLT) in the loop Received more than one REF segment (REF01=EA) in the loop The subscriber is the patient but the TRN segment in loop 22 |
278RQ |
2000C DTP*439 empty/UM0501=AA 2000CorD:DTP Exceeds Max 2000D DTP*439 empty/UM0501=AA 2000F CL1 present/UM01 NE AR 2000F DTP Exceeds Max Occur 2000F DTP Exceeds Occurrence |
278RP |
> 1 DTP01 = 007 ! allowed > 1 DTP01 = 036 ! allowed > 1 DTP01 = 096 ! allowed > 1 DTP01 = 102 ! allowed > 1 DTP01 = 435 ! allowed > 1 DTP01 = 456 ! allowed > 1 DTP01 = 472 ! allowed 2000CorD:DTP Exceeds Max Occur |
820 |
Not applicable |
834 |
2100E NM1 Loop Occurs > 3 1100C N1 Loop Occurs > 2 2000 REF Mem ID > 5 2000 REF01-OF Occurs > 1 2000 REF-IL Occurs > 1 2100A NM1 Loop Occurs > 1 2100B NM1 Loop Occurs > 1 2100C NM1 Loop Occurs > 1 2100F NM1 Loop Occurs > 1 2100G NM1 Loop Occurs > 1 2100D NM1 Loop Occurs > 3 |
835 |
Not applicable |
837D |
2010AA 1st REF Occurs > 5 2010AA 2nd REF Occurs > 8 2010BA 1st REF Exceed Max Occur 2010BA 2nd REF > 1 2010CA 1st REF Occurs > 5 2010CA 2nd REF Occurs > 1 2300 DTP Segment Exceed Occur 2300 REF Exceeds Max Occur 2320 AMT Seg Occur Violation 2330B REF Exceeds Max Occur 2400 DTP Occurs > 1 2400 REF Occurs > 1 |
837I |
1000B missing mandatory seg 2000B SBR04 is required if SBR03 is Empty 2010AA REF01=SY Invalid 2010AA_REF01 cannot be SY 2010AA_REF01 must be EI or SY 2010AB REF01=SY Invalid 2010AB_REF01 cannot be SY 2010AB_REF01 must be EI or SY 2010BA_DMG segment required 2010BA_N3 segment required 2010BA_N4 segment required 2010BA_REF01 cannot be SY 2010BA_REF01 may not be 1W 2010BA-REF01=1W Invalid 2010CA_REF01 cannot be SY 2010CA-REF01=1W Invalid 2310A_REF01 cannot be SY 2310A-Medicare REF01=SY Invalid 2310B Medicare REF01=SY Invalid 2310B_REF01 cannot be SY 2310C Medicare,REF01=SY Invalid 2310C_REF01 cannot be SY 2320 Missing Mandatory DMG 2320B Required segment missing 2330A Missing Required N4 2330A REF01=SY InvalidMedicare 2330A_REF01 cannot be SY 2330A_REF01 may not be 1W 2330B Missing Required N4 2330C Medicare-REF01=SY Invalid 2330C_REF01 cannot be SY 2330C_REF01 may not be 1W 2330F REF01=SY Invalid-Medicare 2330F_REF01 cannot be SY 2420A missing mandatory seg 2420A_REF01 cannot be SY 2420B_REF01 cannot be SY 2420C_REF01 cannot be SY Assessment Date DTP is not used when this segment present DTP 434 mandatory seg missing No. Of CLM Seg < 5000 REF01=SY Invalid For Medicare Claim |
837P |
2000A 1st REF Occurs > 8 2000A 2nd REF Occurs > 8 2010AA - Missing Mandatory REF 2010BA 1st REF Occurs > 4 2010BA 2nd REF Occurs > 1 2010CA 1st REF Occurs > 1 2010CA 2nd REF Occurs > 1 2300 AMT Segments Occurs > 1 2300 CRC Occurs > 1 2300 CRC Occurs > 3 Times DTP Segment Required, when CR301=RorS Invalid REF01 Segment, when NM108=MI Missing DTP segment, DTP01=330 Missing DTP Segment, where DTP01=297 - Date Last Worked Missing REF segment Missing REF segment, REF01=9F Missing REF segment, REF01=F8 Missing Required CR1 Segment Missing Required DTP Segment, DTP01=435 Missing Required DTP Segment, DTP01=453 Missing Required DTP Segment, DTP01=454 Missing Required DTP Segment, DTP01=471 PRV in loop 2000A or 2310B should be present The Mandatory DTP segment ( DTP/01=472 ) in loop 2400, was not found When CLM11 present, DTP01=439 must be present |
This section lists the description, cause, and action to take regarding the 2370 compliance map error.
Description. Invalid loop.
Cause. Violation of gray box rules as described in the HIPAA Implementation Guide.
Action. Change incoming data or instruct the submitter of the data to provide a value in the field.
Map |
Example of text error messages for error code 2370 |
|---|---|
270 |
2000C Invalid HL Loop 2000D Invalid HL Loop Missing Loop 2110C |
271 |
Not applicable |
276 |
Invalid use or HL segment |
277 |
Invalid use or HL segment |
278RQ |
Not applicable |
278RP |
Not applicable |
820 |
Not applicable |
834 |
Not applicable |
835 |
Not applicable |
837D |
1st Loop Iteration, NM101='DN' 1st Loop Iteration, NM101='DN' 2010AA Loop Occurs > 1 2010AA Billing Prov Loop Miss 2010AB Loop Occurs > 1 2010BA Loop Occurs > 1 2010BB Loop Occurs > 1 2010BB Missing Mandatory Loop 201BC Loop Occurs > 1 2310A Loop Occurs > 2 Times 2310C Loop Occurs > 1 Times 2330A Loop Occurs > 1 Time 2330B Loop Occurs > 1 Time 2330C Loop Occurs > 1 Times 2330D Loop Occurs > 1 Time 2330E Loop Occurs > 1 Time 2420A Loop Occurs > 1 Time 2420B Loop Occurs > 1 Time 2nd Loop Iteration, NM101='P3' 2nd Loop Iteration, NM101='P3' HL04 Invalid Loop Value NM101=40 Exceed Max Occur NM101=41 Exceed max Occur |
837I |
2000C Invalid HL Loop 2330A Missing Required Loop LOOP ID - 2400 LX Required |
837P |
1000A NM101=40 Occurs > 1 1000B NM101=41 Occurs > 1 2000A NM101=85 Occurs > 1 2000AB :NM101=87 Occurs > 1 2000BA Missing Subscriber NM1 2010BA NM101=IL Occurs > 1 2010BB NM101=PR Occurs > 1 2010BC NM101=QD Occurs > 1 2010BD NM101=AO Occurs > 1 2010CA NM101=QC Occurs > 1 LX Segment Missing |
This section lists the description, cause, and action to take regarding the 4567 compliance map error.
Description. Required data element missing.
Cause. Information on a required element within a segment is missing in the inbound data.
Action. Add element information in the specified location of the segment.
Map |
Example of text error messages for error code 4567 |
|---|---|
270 |
PER04 is missing, or not Numeric PER06 is missing, or not Numeric PER08 is missing, or not Numeric Required Data Element Missing Required PER03 element missing Required PER05 element missing Required PER07 element missing |
271 |
Missing or mismatched LE segment Missing or mismatched LS segment Required Data Element Missing |
276 |
Required Data Element Missing |
277 |
Required Data Element Missing |
278RQ |
2000C HI elements not consecutive 2000C TRN segment required 2000D HI elements not consecutive 2000D TRN segment required 2000F HI elements not consecutive 2010A NM1 Mandatory segment missing 2010B NM1 Mandatory segment missing 2010C NM1 Mandatory segment missing 2010E Both NM103 and NM109 cannot be NULL 2010E NM1 Mandatory segment missing A TRN segment is required in each Service loop when the requ CR6 -Invalid or Missing HI0101 CR6 requires 2000C or 2000D HI0104 CR6 requires a 2000C HI or 2000D HI segment NM108, NM109 must both be present or not included Required Data Element Missing When UM01=HS and NM108/NM109=blank, PRV is required When UM01=SC and NM108/NM109=blank, PRV is needed |
278RP |
2000A HL Mandatory segment missing 2000B HL Mandatory segment missing 2000C HI elements not consecutive 2000C HL Mandatory segment missing 2000C PWK05 & 06 must both be present or blank 2000C PWK05 is required when PWK02 is not 'VO' 2000D HI elements not consecutive 2000E HL Mandatory segment missing 2000F HI elements not consecutive 2000F HL Mandatory segment missing 2010D NM108, NM109 must both be present or not included 2010E Both NM103 and NM109 cannot be NULL 2010E NM108, NM109 must both be present or not included A 2000C PWK segment is invalid when a 2000D level is present A 2000CB NM1 segment is invalid when a 2000D level is present Required Data Element Missing |
820 |
Required Data Element Missing |
834 |
Missing Mandatory 2000 REF01=0F Required Data Element Missing |
835 |
2102.NM104 is required 2110 Service level DTM segment required when 2100 Claim DTM BPR11 is required when BPR04 = ACH CLP05 Amount does not equal the sum of CAS amounts where CASHDR BPR05 is required HDR.BPR07 is required HDR.BPR08 is required HDR.BPR09 is required HDR.BPR10 is required HDR.BPR12 is required HDR.BPR13 is required HDR.BPR14 is required HDR.BPR15 is required Mandatory 2100 NM1 Patient Name Required Data Element Missing SCV03 is required SVC_0101 cannot equal SVC_0601 SVC_05 cannot equal SVC_07 TS3 required if TS2 present When CLP06 is MA or MB a 2110 level DTM segment is required When CLP06 is MB, LX01 must equal 0 or 1 |
837D |
Required Data Element Missing |
837I |
2300Z Missing Mandatory HI Invalid Amount Required Data Element Missing |
837P |
2010AA Missing Mandatory NM101 2400E DTP Service Date prior to Jan 1 2000 is missing required CR212 Required Data Element Missing When PAT08 is used, data is required in PAT07 |
