X12 HIPAA
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Implementation Acknowledgment (X231)
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X12 999 Implementation Acknowledgment (X231)

X12 Release 5010
Delimiters
  • ~ Segment
  • * Element
  • > Component
  • ^ Repetition
EDI sample
  • Example 1: Response to a Functional Group Containing Three 837s
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Overview
ISA
-
Interchange Control Header
Max use 1
Required
GS
-
Functional Group Header
Max use 1
Required
heading
ST
0100
Transaction Set Header
Max use 1
Required
AK1
0200
Functional Group Response Header
Max use 1
Required
Transaction Set Response Header Loop
AK9
0900
Functional Group Response Trailer
Max use 1
Required
SE
1000
Transaction Set Trailer
Max use 1
Required
GE
-
Functional Group Trailer
Max use 1
Required
IEA
-
Interchange Control Trailer
Max use 1
Required
ISA

Interchange Control Header

RequiredMax use 1
Example
ISA-01
I01
Authorization Information Qualifier
Required
Identifier (ID)
00
No Authorization Information Present (No Meaningful Information in I02)
ISA-02
I02
Authorization Information
Required
String (AN)
Min 10Max 10
ISA-03
I03
Security Information Qualifier
Required
Identifier (ID)
00
No Security Information Present (No Meaningful Information in I04)
ISA-04
I04
Security Information
Required
String (AN)
Min 10Max 10
ISA-05
I05
Interchange ID Qualifier
Required
Identifier (ID)
Min 2Max 2
Codes
ISA-06
I06
Interchange Sender ID
Required
String (AN)
Min 15Max 15
ISA-07
I05
Interchange ID Qualifier
Required
Identifier (ID)
Min 2Max 2
Codes
ISA-08
I07
Interchange Receiver ID
Required
String (AN)
Min 15Max 15
ISA-09
I08
Interchange Date
Required
Date (DT)
YYMMDD format
ISA-10
I09
Interchange Time
Required
Time (TM)
HHMM format
ISA-11
I65
Repetition Separator
Required
String (AN)
Min 1Max 1
^
Repetition Separator
ISA-12
I11
Interchange Control Version Number
Required
Identifier (ID)
00501
Standards Approved for Publication by ASC X12 Procedures Review Board through October 2003
ISA-13
I12
Interchange Control Number
Required
Numeric (N0)
Min 9Max 9
ISA-14
I13
Acknowledgment Requested
Required
Identifier (ID)
Min 1Max 1
0
No Interchange Acknowledgment Requested
1
Interchange Acknowledgment Requested (TA1)
ISA-15
I14
Interchange Usage Indicator
Required
Identifier (ID)
Min 1Max 1
I
Information
P
Production Data
T
Test Data
ISA-16
I15
Component Element Separator
Required
String (AN)
Min 1Max 1
>
Component Element Separator
GS

Functional Group Header

RequiredMax use 1
Example
GS-01
479
Functional Identifier Code
Required
Identifier (ID)
FA
Functional or Implementation Acknowledgment Transaction Sets (997, 999)
GS-02
142
Application Sender's Code
Required
String (AN)
Min 2Max 15
GS-03
124
Application Receiver's Code
Required
String (AN)
Min 2Max 15
GS-04
373
Date
Required
Date (DT)
CCYYMMDD format
GS-05
337
Time
Required
Time (TM)
HHMM, HHMMSS, HHMMSSD, or HHMMSSDD format
GS-06
28
Group Control Number
Required
Numeric (N0)
Min 1Max 9
GS-07
455
Responsible Agency Code
Required
Identifier (ID)
Min 1Max 2
T
Transportation Data Coordinating Committee (TDCC)
X
Accredited Standards Committee X12
GS-08
480
Version / Release / Industry Identifier Code
Required
String (AN)
005010X231

Heading

ST
0100
Heading > ST

Transaction Set Header

RequiredMax use 1
Usage notes
Example
ST-01
143
Transaction Set Identifier Code
Required
Identifier (ID)
999
Implementation Acknowledgment
ST-02
329
Transaction Set Control Number
Required
Numeric (N)
Min 4Max 9
Usage notes
ST-03
1705
Implementation Convention Reference
Required
String (AN)
Usage notes
005010X231
AK1
0200
Heading > AK1

Functional Group Response Header

RequiredMax use 1
Example
AK1-01
479
Functional Identifier Code
Required
Identifier (ID)
Min 2Max 2
Usage notes
AK1-02
28
Group Control Number
Required
Numeric (N0)
Min 1Max 9
Usage notes
AK1-03
480
Version, Release, or Industry Identifier Code
Required
String (AN)
Min 1Max 12
Usage notes
2000 Transaction Set Response Header Loop
OptionalMax >1
AK2
0300
Heading > Transaction Set Response Header Loop > AK2

Transaction Set Response Header

RequiredMax use 1
Usage notes
Example
AK2-01
143
Transaction Set Identifier Code
Required
Identifier (ID)
Min 3Max 3
Usage notes
AK2-02
329
Transaction Set Control Number
Required
Numeric (N)
Min 4Max 9
Usage notes
AK2-03
1705
Implementation Convention Reference
Optional
String (AN)
Min 1Max 35
Usage notes
2100 Error Identification Loop
OptionalMax >1
IK3
0400
Heading > Transaction Set Response Header Loop > Error Identification Loop > IK3

Error Identification

RequiredMax use 1
Usage notes
Example
IK3-01
721
Segment ID Code
Required
Identifier (ID)
Min 2Max 3
IK3-02
719
Segment Position in Transaction Set
Required
Numeric (N0)
Min 1Max 10
Usage notes
IK3-03
447
Loop Identifier Code
Optional
String (AN)
Min 1Max 4
Usage notes
IK3-04
620
Implementation Segment Syntax Error Code
Required
Identifier (ID)
1
Unrecognized segment ID
2
Unexpected segment
3
Required Segment Missing
4
Loop Occurs Over Maximum Times
5
Segment Exceeds Maximum Use
6
Segment Not in Defined Transaction Set
7
Segment Not in Proper Sequence
8
Segment Has Data Element Errors
I4
Implementation "Not Used" Segment Present
I6
Implementation Dependent Segment Missing
I7
Implementation Loop Occurs Under Minimum Times
I8
Implementation Segment Below Minimum Use
I9
Implementation Dependent "Not Used" Segment Present
CTX
0500
Heading > Transaction Set Response Header Loop > Error Identification Loop > CTX

Segment Context

OptionalMax use 9
Usage notes
Example
Variants (all may be used)
CTXBusiness Unit Identifier
CTX-01
C998
Context Identification
RequiredMax use 10
Holds information to identify a context
C998-01
9999
Context Name
Required
String (AN)
Min 1Max 35
Usage notes
CTX-02
721
Segment ID Code
Required
Identifier (ID)
Min 2Max 3
CTX-03
719
Segment Position in Transaction Set
Required
Numeric (N0)
Min 1Max 10
CTX-04
447
Loop Identifier Code
Optional
String (AN)
Min 1Max 4
Usage notes
CTX-05
C030
Position in Segment
OptionalMax use 1
Code indicating the relative position of the simple data element or composite data structure in error within a segment, count beginning with 1 for the position immediately following the segment ID; additionally indicating the relative position of a repeating structure in error, count beginning with 1 for the position immediately following the preceding element separator; additionally indicating the relative position of a component of a composite data structure in error, count beginning with 1 for the position following the preceding element or repetition separator
Usage notes
C030-01
722
Element Position in Segment
Required
Numeric (N0)
Min 1Max 2
C030-02
1528
Component Data Element Position in Composite
Optional
Numeric (N0)
Min 1Max 2
C030-03
1686
Repeating Data Element Position
Optional
Numeric (N0)
Min 1Max 4
CTX-06
C999
Reference in Segment
OptionalMax use 1
To hold the reference number of a data element and optionally a component data element within a composite
Usage notes
C999-01
725
Data Element Reference Number
Required
Numeric (N0)
Min 1Max 4
CTX
0500
Heading > Transaction Set Response Header Loop > Error Identification Loop > CTX

Business Unit Identifier

OptionalMax use 1
Usage notes
Example
Variants (all may be used)
CTXSegment Context
CTX-01
C998
Context Identification
RequiredMax use 10
Holds information to identify a context
C998-01
9999
Context Name
Required
String (AN)
Min 1Max 35
Usage notes
C998-02
9998
Context Reference
Required
String (AN)
Min 1Max 35
Usage notes
2110 Implementation Data Element Note Loop
OptionalMax >1
IK4
0600
Heading > Transaction Set Response Header Loop > Error Identification Loop > Implementation Data Element Note Loop > IK4

Implementation Data Element Note

RequiredMax use 1
Usage notes
Example
IK4-01
C030
Position in Segment
RequiredMax use 1
Code indicating the relative position of the simple data element or composite data structure in error within a segment, count beginning with 1 for the position immediately following the segment ID; additionally indicating the relative position of a repeating structure in error, count beginning with 1 for the position immediately following the preceding element separator; additionally indicating the relative position of a component of a composite data structure in error, count beginning with 1 for the position following the preceding element or repetition separator
C030-01
722
Element Position in Segment
Required
Numeric (N0)
Min 1Max 2
C030-02
1528
Component Data Element Position in Composite
Optional
Numeric (N0)
Min 1Max 2
C030-03
1686
Repeating Data Element Position
Optional
Numeric (N0)
Min 1Max 4
IK4-02
725
Data Element Reference Number
Optional
Numeric (N0)
Min 1Max 4
IK4-03
621
Implementation Data Element Syntax Error Code
Required
Identifier (ID)
1
Required Data Element Missing
2
Conditional Required Data Element Missing
3
Too Many Data Elements
4
Data Element Too Short
5
Data Element Too Long
6
Invalid Character In Data Element
7
Invalid Code Value
8
Invalid Date
9
Invalid Time
10
Exclusion Condition Violated
12
Too Many Repetitions
13
Too Many Components
I10
Implementation "Not Used" Data Element Present
I11
Implementation Too Few Repetitions
I12
Implementation Pattern Match Failure
I13
Implementation Dependent "Not Used" Data Element Present
I6
Code Value Not Used in Implementation
I9
Implementation Dependent Data Element Missing
IK4-04
724
Copy of Bad Data Element
Optional
String (AN)
Min 1Max 99
CTX
0700
Heading > Transaction Set Response Header Loop > Error Identification Loop > Implementation Data Element Note Loop > CTX

Element Context

OptionalMax use 10
Usage notes
Example
CTX-01
C998
Context Identification
RequiredMax use 10
Holds information to identify a context
C998-01
9999
Context Name
Required
String (AN)
Min 1Max 35
Usage notes
CTX-02
721
Segment ID Code
Required
Identifier (ID)
Min 2Max 3
CTX-03
719
Segment Position in Transaction Set
Required
Numeric (N0)
Min 1Max 10
CTX-04
447
Loop Identifier Code
Optional
String (AN)
Min 1Max 4
Usage notes
CTX-05
C030
Position in Segment
OptionalMax use 1
Code indicating the relative position of the simple data element or composite data structure in error within a segment, count beginning with 1 for the position immediately following the segment ID; additionally indicating the relative position of a repeating structure in error, count beginning with 1 for the position immediately following the preceding element separator; additionally indicating the relative position of a component of a composite data structure in error, count beginning with 1 for the position following the preceding element or repetition separator
Usage notes
C030-01
722
Element Position in Segment
Required
Numeric (N0)
Min 1Max 2
C030-02
1528
Component Data Element Position in Composite
Optional
Numeric (N0)
Min 1Max 2
C030-03
1686
Repeating Data Element Position
Optional
Numeric (N0)
Min 1Max 4
CTX-06
C999
Reference in Segment
OptionalMax use 1
To hold the reference number of a data element and optionally a component data element within a composite
Usage notes
C999-01
725
Data Element Reference Number
Required
Numeric (N0)
Min 1Max 4
2110 Implementation Data Element Note Loop end
2100 Error Identification Loop end
IK5
0800
Heading > Transaction Set Response Header Loop > IK5

Transaction Set Response Trailer

RequiredMax use 1
Example
IK5-01
717
Transaction Set Acknowledgment Code
Required
Identifier (ID)
A
Accepted
E
Accepted But Errors Were Noted
M
Rejected, Message Authentication Code (MAC) Failed
R
Rejected
W
Rejected, Assurance Failed Validity Tests
X
Rejected, Content After Decryption Could Not Be Analyzed
IK5-02
618
Implementation Transaction Set Syntax Error Code
Optional
Identifier (ID)
1
Transaction Set Not Supported
2
Transaction Set Trailer Missing
3
Transaction Set Control Number in Header and Trailer Do Not Match
4
Number of Included Segments Does Not Match Actual Count
5
One or More Segments in Error
6
Missing or Invalid Transaction Set Identifier
7
Missing or Invalid Transaction Set Control Number
8
Authentication Key Name Unknown
9
Encryption Key Name Unknown
10
Requested Service (Authentication or Encrypted) Not Available
11
Unknown Security Recipient
12
Incorrect Message Length (Encryption Only)
13
Message Authentication Code Failed
15
Unknown Security Originator
16
Syntax Error in Decrypted Text
17
Security Not Supported
18
Transaction Set not in Functional Group
19
Invalid Transaction Set Implementation Convention Reference
23
Transaction Set Control Number Not Unique within the Functional Group
24
S3E Security End Segment Missing for S3S Security Start Segment
25
S3S Security Start Segment Missing for S3E Security End Segment
26
S4E Security End Segment Missing for S4S Security Start Segment
27
S4S Security Start Segment Missing for S4E Security End Segment
I5
Implementation One or More Segments in Error
I6
Implementation Convention Not Supported
IK5-03
618
Implementation Transaction Set Syntax Error Code
Optional
Identifier (ID)
Min 1Max 3
IK5-04
618
Implementation Transaction Set Syntax Error Code
Optional
Identifier (ID)
Min 1Max 3
IK5-05
618
Implementation Transaction Set Syntax Error Code
Optional
Identifier (ID)
Min 1Max 3
IK5-06
618
Implementation Transaction Set Syntax Error Code
Optional
Identifier (ID)
Min 1Max 3
2000 Transaction Set Response Header Loop end
AK9
0900
Heading > AK9

Functional Group Response Trailer

RequiredMax use 1
Example
AK9-01
715
Functional Group Acknowledge Code
Required
Identifier (ID)
A
Accepted
E
Accepted, But Errors Were Noted.
M
Rejected, Message Authentication Code (MAC) Failed
P
Partially Accepted, At Least One Transaction Set Was Rejected
R
Rejected
W
Rejected, Assurance Failed Validity Tests
X
Rejected, Content After Decryption Could Not Be Analyzed
AK9-02
97
Number of Transaction Sets Included
Required
Numeric (N0)
Min 1Max 6
AK9-03
123
Number of Received Transaction Sets
Required
Numeric (N0)
Min 1Max 6
AK9-04
2
Number of Accepted Transaction Sets
Required
Numeric (N0)
Min 1Max 6
AK9-05
716
Functional Group Syntax Error Code
Optional
Identifier (ID)
1
Functional Group Not Supported
2
Functional Group Version Not Supported
3
Functional Group Trailer Missing
4
Group Control Number in the Functional Group Header and Trailer Do Not Agree
5
Number of Included Transaction Sets Does Not Match Actual Count
6
Group Control Number Violates Syntax
10
Authentication Key Name Unknown
11
Encryption Key Name Unknown
12
Requested Service (Authentication or Encryption) Not Available
13
Unknown Security Recipient
14
Unknown Security Originator
15
Syntax Error in Decrypted Text
16
Security Not Supported
17
Incorrect Message Length (Encryption Only)
18
Message Authentication Code Failed
19
Functional Group Control Number not Unique within Interchange
23
S3E Security End Segment Missing for S3S Security Start Segment
24
S3S Security Start Segment Missing for S3E End Segment
25
S4E Security End Segment Missing for S4S Security Start Segment
26
S4S Security Start Segment Missing for S4E Security End Segment
AK9-06
716
Functional Group Syntax Error Code
Optional
Identifier (ID)
Min 1Max 3
AK9-07
716
Functional Group Syntax Error Code
Optional
Identifier (ID)
Min 1Max 3
AK9-08
716
Functional Group Syntax Error Code
Optional
Identifier (ID)
Min 1Max 3
AK9-09
716
Functional Group Syntax Error Code
Optional
Identifier (ID)
Min 1Max 3
SE
1000
Heading > SE

Transaction Set Trailer

RequiredMax use 1
Example
SE-01
96
Number of Included Segments
Required
Numeric (N0)
Min 1Max 10
SE-02
329
Transaction Set Control Number
Required
Numeric (N)
Min 4Max 9
Usage notes
Heading end
GE

Functional Group Trailer

RequiredMax use 1
Example
GE-01
97
Number of Transaction Sets Included
Required
Numeric (N0)
Min 1Max 6
GE-02
28
Group Control Number
Required
Numeric (N0)
Min 1Max 9
IEA

Interchange Control Trailer

RequiredMax use 1
Example
IEA-01
I16
Number of Included Functional Groups
Required
Numeric (N0)
Min 1Max 5
IEA-02
I12
Interchange Control Number
Required
Numeric (N0)
Min 9Max 9
EDI Samples

Example 1: Response to a Functional Group Containing Three 837s

ISA*00* *00* *ZZ*123456789012345*ZZ*123456789012346*080503*1705*^*00501*000010216*0*T*>~
GS*FA*1234567890*2345678901*20080503*1705*20213*X*005010X231~
ST*999*2870001*005010X231~
AK1*HC*17456*005010X222A2~
AK2*837*0001~
IK5*A~
AK2*837*0002~
IK3*CLM*22**8~
CTX*CLM01>123456789~
IK4*2*782*1~
IK5*R*5~
AK2*837*0003~
IK3*REF*57**3~
CTX*SITUATIONAL TRIGGER*CLM*43**5>3~
CTX*CLM01>987654321~
IK5*R*5~
AK9*P*3*3*1~
SE*16*2870001~
GE*1*20213~
IEA*1*000010216~

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