Product: Transaction Manager
Article Link: http://help.truecommerce.com/en/articles/5083010-transaction-manager-how-to-read-a-997-999-functional-acknowledgment
Version 5010 HIPAA Transactions
1. Version/Industry Group ID GS08 Changes
Message ID | Group Codes | Version 004010 / Industry Identifier | Version 005010 / Industry Identifier |
270 | HS | 004010X092A1 | 005010X279 |
271 | HB | 004010X092A1 | 005010X279 |
276 | HR | 004010X093A1 | 005010X212 |
277 | HN | 004010X093A1 | 005010X212 |
278 | HI | 004010X094A1 | 005010X217 |
820 | RA | 004010X061A1 | 005010X218 |
834 | BE | 004010X095A1 | 005010X220 |
835 | HP | 004010X091A1 | 005010X221 |
837Prof | HC | 004010X098A1 | 005010X222 |
837Inst HC | HC | 004010X096A1 | 005010X223A1 |
837Dent | HC | 004010X097A1 | 005010X224A1 |
2. ST03 Added
The ST03 element was added to all of the above transactions. This element contains the same value as GS08. Some EDI translation products omit the ISA and GS segments (envelopes) prior to application (ST-SE) processing. By providing the information from GS08 at this level, it will ensure that the appropriate application mapping is used at translation time.
3. 999 Implementation Acknowledgment
The 999 Implementation Acknowledgment transaction is an EDI response message to confirm a file was received and could be properly read by the translator. The 999 can also report on exactly what syntax-related issue caused the errors on the original document. It can notify the sender whether the document was accepted or rejected. While the 999 will acknowledge receipt of the sent document, it does not guarantee that the transaction will be put in use by the business process. For example, just because an acknowledgment is sent does not guarantee a “Claim” will be processed through the adjudication system.
999 Acknowledgment Result Types: | A – Accepted R – Rejected E – Accepted with errors |
999 Acknowledgment Sample Data: | ST*999*0001*005010X231~ AK1*HC*6454*005010X231~ AK2*837*0001*005010X231~ IK3*CLM*120**8~ IK4*2*782*I12*92.511~ IK5*E~ AK9*A*1*1*1~ SE*8*0001~ |
AK1: | This segment refers to the (GS) group level of the original document. |
| AK101 is equal to GS01 from the original document. For example, for a Claim, AK101= ‘HC’; for an Eligibility Inquiry, AK101 = ‘HS’ AK102 is equal to GS06 from the original document (Group Control Number) AK103 is equal to GS08 from the original document (EDI Implementation Version) |
AK2: | This segment refers to the (ST) Transaction Set level of the document |
| AK201 is equal to ST01 from the original document. For example, for a Claim, AK201= ‘837’; for an Eligibility Inquiry, AK201 = ‘270’ AK202 is equal to ST02 from the original document (Transaction Set Control Number) AK203 is equal to ST03 from the original document (EDI Implementation Version) |
IK3: | This segment reports errors in a data segment and identifies the location of the data segment |
| IK301 contains the segment name that has the error. For example, the segment name is ‘CLM’ IK302 contains the numerical count position of this data segment from the start of the transaction set. For example, the erroneous ‘CLM’ segment is in the 120th position IK303 contains the loop ID where the error occurred. IK304 contains the error code and it states the specific error. For example, the code ‘8’ states “Segment Has Data Element Errors” |
IK4: | This segment reports errors in a data element and identifies the location of the data element |
| IK401 contains the data element position in the segment that is in error. For example, the error is in position 2; CLM-02 IK402 contains the data element reference number, CLM-02 = ‘782’ IK403 contains the error code and states the specific error. For the example, the code ‘I12’ states “Implementation Pattern Match Failure”; IK404 contains a copy of the bad data element data. |
IK5: | This segment reports errors in a transaction set |
| IK501 indicates states whether the whole document is ‘A’ (Accepted), ‘R’ (Rejected) or ‘E’ (Accepted with errors). Other codes such as ‘M’, ‘W’ or ‘X’ are available but are rarely used (for security decryption purposes). For example, IK501 = ‘E’ that means the claim was accepted with errors IK502 is not used in the example above IK506 is to report an error code for the full transaction. IK502 sample error codes include:
1 - Transaction Set Not Supported 2 - Transaction Set Trailer Missing 3 - Transaction Set Control Number in Header and Trailer Do Not Match |
Related Topics
rev: 12/11/23