277 - Health Care Information Status Notification

FUNCTIONAL GROUP=HN

This X12 Transaction Set contains the format and establishes the data contents of the Health Care Information Status Notification Transaction Set (277) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used by a health care payer or authorized agent to notify a provider, recipient, or authorized agent regarding the status of a health care claim or encounter or to request additional information from the provider regarding a health care claim or encounter, health care services review, or transactions related to the provisions of health care. This transaction set is not intended to replace the Health Care Claim Payment/Advice Transaction Set (835) and therefore, will not be used for account payment posting. The notification may be at a summary or service line detail level. The notification may be solicited or unsolicited.

SCHEMA

ST

Segment	Name	Position
ST	Transaction Set Header	0100
BHT	Beginning of Hierarchical Transaction	0200
REF	Reference Information	0300

1000

Segment	Name	Position
NM1	Individual or Organizational Name	0400
N2	Additional Name Information	0500
N3	Party Location	0600
N4	Geographic Location	0700
REF	Reference Information	0800
PER	Administrative Communications Contact	0900

2000

Segment	Name	Position
HL	Hierarchical Level	0100
SBR	Subscriber Information	0200
PAT	Patient Information	0300
DMG	Demographic Information	0400

2100

Segment	Name	Position
NM1	Individual or Organizational Name	0500
N3	Party Location	0600
N4	Geographic Location	0700
PER	Administrative Communications Contact	0800

2200

Segment	Name	Position
TRN	Trace	0900
STC	Status Information	1000
REF	Reference Information	1100
DTP	Date or Time or Period	1200
QTY	Quantity Information	1210
AMT	Monetary Amount Information	1220

2210

Segment	Name	Position
PWK	Paperwork	1300
PER	Administrative Communications Contact	1400
N1	Party Identification	1500
N3	Party Location	1600
N4	Geographic Location	1700

2220

Segment	Name	Position
SVC	Service Information	1800
STC	Status Information	1900
REF	Reference Information	2000
DTP	Date or Time or Period	2100
TOO	Tooth Identification	2150

2225

Segment	Name	Position
PWK	Paperwork	2200
PER	Administrative Communications Contact	2300
N1	Party Identification	2400
N3	Party Location	2500
N4	Geographic Location	2600
SE	Transaction Set Trailer	2700

COMMENTS

Notes
2/0200	The SBR segment may only appear at the Subscriber (HL03=22) level.
2/0400	The DMG segment may only appear at the Subscriber (HL03=22) or Dependent (HL03=23) level.
Comments
2/1300	The 2210 loop may be used when there is a status notification or a request for additional information about a particular claim.
2/2200	The 2225 loop may be used when there is a status notification or a request for additional information about a particular service line.

rev 02/12/2024