X12 275 Patient Information (X210)
j4
- ~ Segment
- * Element
- > Component
- ^ Repetition
Interchange Control Header
To start and identify an interchange of zero or more functional groups and interchange-related control segments
Code identifying the type of information in the Authorization Information
- 00
- No Authorization Information Present (No Meaningful Information in I02)
Information used for additional identification or authorization of the interchange sender or the data in the interchange; the type of information is set by the Authorization Information Qualifier (I01)
Code identifying the type of information in the Security Information
- 00
- No Security Information Present (No Meaningful Information in I04)
This is used for identifying the security information about the interchange sender or the data in the interchange; the type of information is set by the Security Information Qualifier (I03)
Code indicating the system/method of code structure used to designate the sender or receiver ID element being qualified
Identification code published by the sender for other parties to use as the receiver ID to route data to them; the sender always codes this value in the sender ID element
Code indicating the system/method of code structure used to designate the sender or receiver ID element being qualified
Identification code published by the receiver of the data; When sending, it is used by the sender as their sending ID, thus other parties sending to them will use this as a receiving ID to route data to them
Type is not applicable; the repetition separator is a delimiter and not a data element; this field provides the delimiter used to separate repeated occurrences of a simple data element or a composite data structure; this value must be different than the data element separator, component element separator, and the segment terminator
- ^
- Repetition Separator
Code specifying the version number of the interchange control segments
- 00501
- Standards Approved for Publication by ASC X12 Procedures Review Board through October 2003
A control number assigned by the interchange sender
Code indicating sender's request for an interchange acknowledgment
- 0
- No Interchange Acknowledgment Requested
- 1
- Interchange Acknowledgment Requested (TA1)
Code indicating whether data enclosed by this interchange envelope is test, production or information
- I
- Information
- P
- Production Data
- T
- Test Data
Type is not applicable; the component element separator is a delimiter and not a data element; this field provides the delimiter used to separate component data elements within a composite data structure; this value must be different than the data element separator and the segment terminator
- >
- Component Element Separator
Functional Group Header
To indicate the beginning of a functional group and to provide control information
Code identifying a group of application related transaction sets
- PI
- Patient Information (275)
Code identifying party sending transmission; codes agreed to by trading partners
Code identifying party receiving transmission; codes agreed to by trading partners
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
Time expressed in 24-hour clock time as follows: HHMM, or HHMMSS, or HHMMSSD, or HHMMSSDD, where H = hours (00-23), M = minutes (00-59), S = integer seconds (00-59) and DD = decimal seconds; decimal seconds are expressed as follows: D = tenths (0-9) and DD = hundredths (00-99)
Assigned number originated and maintained by the sender
Code identifying the issuer of the standard; this code is used in conjunction with Data Element 480
- T
- Transportation Data Coordinating Committee (TDCC)
- X
- Accredited Standards Committee X12
Code indicating the version, release, subrelease, and industry identifier of the EDI standard being used, including the GS and GE segments; if code in DE455 in GS segment is X, then in DE 480 positions 1-3 are the version number; positions 4-6 are the release and subrelease, level of the version; and positions 7-12 are the industry or trade association identifiers (optionally assigned by user); if code in DE455 in GS segment is T, then other formats are allowed
- 005010X210
Heading
275 Transaction Header
To indicate the start of a transaction set and to assign a control number
Code uniquely identifying a Transaction Set
- The transaction set identifier (ST01) is used by the translation routines of the interchange partners to select the appropriate transaction set definition (e.g., 810 selects the Invoice Transaction Set).
- Use this code to identify the transaction set ID for the transaction set that will follow the ST segment. Each X12 standard has a transaction set identifier code that is unique to that transaction set.
- 275
- Patient Information
Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set
- The Transaction Set Control Number in ST02 and SE02 must be identical. The number is assigned by the originator and must be unique within a functional group (GS-GE). For example, start with the number 0001 and increment from there.
Reference assigned to identify Implementation Convention
- The implementation convention reference (ST03) is used by the translation routines of the interchange partners to select the appropriate implementation convention to match the transaction set definition. When used, this implementation convention reference takes precedence over the implementation reference specified in the GS08.
- This data element contains the same value as GS08. Some translator products strip off the ISA and GS segments prior to application (ST-SE) processing. Providing the information from the GS08 at this level will ensure that the appropriate application mapping is utilized at translation time.
- This value is always 005010X210.
- 005010X210
Beginning Segment
To indicate the beginning of a transaction set
Code identifying purpose of transaction set
- 02
- Add
Used when submitting an attachment to an unsolicited 837.
- 11
- Response
Used when submitting Attachment information in response to a 277.
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
- BGN02 is the transaction set reference number.
- The originator of the transaction set assigns the unique reference number in BGN02 and the date of creation in BGN03.
Date expressed as CCYYMMDD where CC represents the first two digits of the calendar year
- BGN03 is the transaction set date.
Payer Name
To supply the full name of an individual or organizational entity
Code identifying an organizational entity, a physical location, property or an individual
- PR
- Payer
Code qualifying the type of entity
- NM102 qualifies NM103.
- 2
- Non-Person Entity
Code designating the system/method of code structure used for Identification Code (67)
- PI
- Payor Identification
- XV
- Centers for Medicare and Medicaid Services PlanID
Payer Contact Information
To identify a person or office to whom administrative communications should be directed
- Required when the value in BGN01 is 11 and the Payer Response Contact Information (PER Segment) was reported in the 2210D loop of the 277 transaction. If not required by this implementation guide, do not send.
- When the communication number represents a telephone number in the United States and other countries using the North American Dialing Plan (for voice, data, fax, etc.), the communication number should always include the area code and phone number using the format AAABBBCCCC. Where AAA is the area code, BBB is the telephone number prefix, and CCCC is the telephone number (e.g. (534)224-2525 would be represented as 5342242525). The telephone extension, when applicable, should be included in the next sequential communication number data element.
Code identifying the major duty or responsibility of the person or group named
- IC
- Information Contact
Code identifying the type of communication number
- ED
- Electronic Data Interchange Access Number
- EM
- Electronic Mail
- FX
- Facsimile
- TE
- Telephone
Complete communications number including country or area code when applicable
Code identifying the type of communication number
- ED
- Electronic Data Interchange Access Number
- EM
- Electronic Mail
- EX
- Telephone Extension
- FX
- Facsimile
- TE
- Telephone
Complete communications number including country or area code when applicable
Code identifying the type of communication number
- ED
- Electronic Data Interchange Access Number
- EM
- Electronic Mail
- EX
- Telephone Extension
- FX
- Facsimile
- TE
- Telephone
Complete communications number including country or area code when applicable
Submitter Information
To supply the full name of an individual or organizational entity
Code identifying an organizational entity, a physical location, property or an individual
- 41
- Submitter
Code qualifying the type of entity
- NM102 qualifies NM103.
- 1
- Person
- 2
- Non-Person Entity
Individual last name or organizational name
Individual middle name or initial
Code designating the system/method of code structure used for Identification Code (67)
- 46
- Electronic Transmitter Identification Number (ETIN)
Provider Name Information
To supply the full name of an individual or organizational entity
- In the solicited 275 model, the information from the 2100C NM1 segment of the 277 must be returned in this segment.
- In the unsolicited 275 model, the billing provider information must be sent in this segment.
Code identifying an organizational entity, a physical location, property or an individual
- 1P
- Provider
Code qualifying the type of entity
- NM102 qualifies NM103.
- 1
- Person
- 2
- Non-Person Entity
Individual last name or organizational name
Code designating the system/method of code structure used for Identification Code (67)
- XX
- Centers for Medicare and Medicaid Services National Provider Identifier
Required when the National Provider Identifier is mandated for use and the provider is a covered health care provider under the mandate.
Provider Taxonomy Information
To specify the identifying characteristics of a provider
- Required when the payer's adjudication is known to be impacted by the provider taxonomy code. If not required by this implementation guide, do not send.
Code qualifying the Reference Identification
- PXC
- Health Care Provider Taxonomy Code
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Provider Secondary Identification
To specify identifying information
- Required when the provider is not covered under the NPI mandate. If not required by this implementation guide, do not send.
Code qualifying the Reference Identification
- 0B
- State License Number
- 1G
- Provider UPIN Number
- G2
- Provider Commercial Number
This code designates a proprietary provider number for the destination payer identified in the Payer Name Loop associated with this claim. This may be used by all payers including: Medicare, Medicaid, Blue Cross, etc.
- LU
- Location Number
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Provider Identification
To define the attributes of a property or an entity
- The provider address information in this loop applies to the provider information listed in the 1000C loop.
Code identifying an organizational entity, a physical location, property or an individual
- 1P
- Provider
Provider Address
To specify the location of the named party
Provider City, State, ZIP Code
To specify the geographic place of the named party
Free-form text for city name
- A combination of either N401 through N404, or N405 and N406 may be adequate to specify a location.
Code (Standard State/Province) as defined by appropriate government agency
- N402 is required only if city name (N401) is in the U.S. or Canada.
Code defining international postal zone code excluding punctuation and blanks (zip code for United States)
Code identifying the country
- Use the alpha-2 country codes from Part 1 of ISO 316.
Code identifying the country subdivision
- Use the country subdivision codes from Part 2 of ISO 3166.
Patient Name
To supply the full name of an individual or organizational entity
Code identifying an organizational entity, a physical location, property or an individual
- QC
- Patient
Code qualifying the type of entity
- NM102 qualifies NM103.
- 1
- Person
Individual last name or organizational name
Individual middle name or initial
Code designating the system/method of code structure used for Identification Code (67)
- II
- Standard Unique Health Identifier for each Individual in the United States
Required if the HIPAA Individual Patient Identifier is mandated for use. Otherwise, another listed code must be used.
- MI
- Member Identification Number
The code "MI" is intended to be the patient's identification number as assigned by the payer. Payers use different terminology to convey the same number. The Member Identification Number is used to convey the following terms: Insured's ID, Subscriber's ID, Health Insurance Claim Number (HIC), etc.
Code identifying a party or other code
Patient Control Number
To specify identifying information
- When the value in BGN01 of the 275 is 02, the Patient Control Number must be the same number as reported in CLM01 of the 2300 loop in the 837. When the value in BGN01 is 11, the Patient Control Number must be the same number as reported in REF02 of the 2200D loop in the 277.
Code qualifying the Reference Identification
- EJ
- Patient Account Number
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
- The maximum number of characters to be supported for this data element is "20". A provider may submit fewer characters depending upon their needs. However, the HIPAA maximum requirement to be supported by any responding system is "20". Characters beyond "20" are not required to be stored nor returned by any 837 receiving system.
Institutional Type Of Bill
To specify identifying information
- Required when the Institutional Type of Bill from the submitted claim is available in the payer's system and is included in the 2200D REF segment of the 277. If not required by this implementation guide, do not send.
Code qualifying the Reference Identification
- BLT
- Billing Type
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
- The value in REF02 corresponds to a concatenation of Facility Type Code (CLM05-1) and Claim Frequency Type Code (CLM05-3) from the ASC X12N 837 claim transaction or this is the value from REF02 in the 2200D loop of the 277.
Medical Record Identification Number
To specify identifying information
- Required when the Medical Record Identification Number is submitted on the original claim. If not required by this implementation guide, may be provided at the sender's discretion, but cannot be required by the receiver.
Code qualifying the Reference Identification
- EA
- Medical Record Identification Number
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
- This is the Medical Record Identification Number from the original claim.
Claim Identification Number for Clearinghouses and Other Transmission Intermediaries
To specify identifying information
- Required when this claim identification number is sent in the 2200D REF segment of the 277. If not required by this implementation guide, do not send.
- Although this REF is supplied for transmission intermediaries to attach their own unique claim number to a claim/encounter, trading partners are not required under HIPAA to return this number in any HIPAA transaction. Trading partners may voluntarily agree to this interaction if they wish.
Code qualifying the Reference Identification
- D9
- Claim Number
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
- The value carried in this element is limited to a maximum of 20 positions.
Claim Service Date
To specify any or all of a date, a time, or a time period
- Required when the information submitted or requested applies to the entire claim. If not required by this implementation guide, may be provided at the sender's discretion but can not be required by the receiver.
Code specifying type of date or time, or both date and time
- 472
- Service
Code indicating the date format, time format, or date and time format
- DTP02 is the date or time or period format that will appear in DTP03.
- D8
- Date Expressed in Format CCYYMMDD
- RD8
- Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD
RD8 is required only when the To and From dates are different.
Expression of a date, a time, or range of dates, times or dates and times
Detail
Assigned Number
To reference a line number in a transaction set
- Within the LX, LX01 is the sequence number of the segments that follow. The LX01 sequence number must start at 1 and increment by 1.
- The LX segment can be repeated to respond to multiple questions on an individual claim. The 275 transaction structure only allows the submitter to send one claim in each 275. A separate Transaction Set Header/Trailer (ST/SE) must be sent for each claim.
Number assigned for differentiation within a transaction set
- Within the LX, LX01 is the sequence number of the segments that follow. The LX01 sequence number must start at 1 and increment by 1.
Payer Claim Control Number/Provider Attachment Control Number
To uniquely identify a transaction to an application
- Payer Claim Control Number is the value from the TRN segment loop 2200D of the 277 when in response to a solicited request.
- The TRN02 value must be the same in each iteration of the 2000A loop when the value in TRN02 is the Payer claim control number.
- For the unsolicited 275, the Attachment Control Number is the value from PWK06 loop 2300 of the 837. This is the main matching criteria and must be unique on a per attachment basis.
Code identifying which transaction is being referenced
- 1
- Current Transaction Trace Numbers
Used when sending an unsolicited 275 to support an 837.
- 2
- Referenced Transaction Trace Numbers
Used when responding to a 277.
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
- TRN02 provides unique identification for the transaction.
- When the value in BGN01 is 11, this number will be the payer claim control number that is in TRN02 of the 2200D loop, in the 277. This value must be the same in each LX loop.
- When the value in BGN01 is 02, this number is the unique control number that the provider assigned for the attachment. It must match the number in PWK06 loop 2300 of the 837. This is the main matching criteria and must be unique on a per attachment basis. When using the Attachment Control Number the minimum length requirement is 2. For the unsolicited 275, payers and clearinghouses may ensure a match of the 275 attachment to the claim by concatenating other data in this transaction to the value in TRN02.
- The payer does not set the format for the Attachment Control Number. However, the payer may have some system constraints, e.g. maximum readable length, that the provider needs to take into account when formatting this Control Number.
Status Information
To report the status, required action, and paid information of a claim or service line
- Required when the value in BGN01 is 11 (Response). If not required by this implementation guide, do not send.
Code indicating a code from a specific industry code list
- C043-01 is used to specify the logical groupings of Health Care Claim Status Codes (See Code Source 507).
- This is the Category Code. For this implementation the value must be a category code beginning with `R'.
- See Code Source 507: Health Care Claim Status Category Code
Code indicating a code from a specific industry code list
- C043-02 is used to identify the status of an entire claim or a serviceline.
Code Source 508 is referenced unless qualified by C043-04.
- This will be the LOINC® Code that defines the additional information that was requested.
- See Code Source 663: Logical Observation Identifier Names and Codes (LOINC®)
Code identifying a specific industry code list
- C043-04 is used to identify the Code Source referenced in C043-02.
- LOI
- Logical Observation Identifier Names and Codes (LOINC<190>) Codes
Required when the 277 STC10 is used. If not required by this implementation guide, do not send.
Code indicating a code from a specific industry code list
- C043-01 is used to specify the logical groupings of Health Care Claim Status Codes (See Code Source 507).
- This is the Category Code.
- See Code Source 507: Health Care Claim Status Category Code
Code indicating a code from a specific industry code list
- C043-02 is used to identify the status of an entire claim or a serviceline.
Code Source 508 is referenced unless qualified by C043-04.
- This will be the LOINC® modifier that clarifies the additional information that was requested.
- See Code Source 663: Logical Observation Identifier Names and Codes (LOINC®)
Code identifying a specific industry code list
- C043-04 is used to identify the Code Source referenced in C043-02.
- LOI
- Logical Observation Identifier Names and Codes (LOINC<190>) Codes
Required when the 277 STC11 is used. If not required by this implementation guide, do not send.
Code indicating a code from a specific industry code list
- C043-01 is used to specify the logical groupings of Health Care Claim Status Codes (See Code Source 507).
- This is the Category Code.
- See Code Source 507: Health Care Claim Status Category Code
Code indicating a code from a specific industry code list
- C043-02 is used to identify the status of an entire claim or a serviceline.
Code Source 508 is referenced unless qualified by C043-04.
- This will be the LOINC® modifier that clarifies the additional information that was requested.
- See Code Source 663: Logical Observation Identifier Names and Codes (LOINC®)
Code identifying a specific industry code list
- C043-04 is used to identify the Code Source referenced in C043-02.
- LOI
- Logical Observation Identifier Names and Codes (LOINC<190>) Codes
Service Line Item Identification
To specify identifying information
- Required when the additional information is associated with the service line or revenue line information. If not required by this implementation guide, do not send.
- If this segment is used, then there will be a REF segment that contains the Procedure Code or Revenue Code.
Code qualifying the Reference Identification
- 6R
- Provider Control Number
Used when the value in BGN01 is 02. This is the Provider Control Number for the line that is reported in the 837 in loop 2400 on the original claim.
- FJ
- Line Item Control Number
Used when the value in BGN01 is 11. This is the Line Item Control Number that is reported in the 277.
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
- This is the provider control number or the line item control number that is associated with the additional information.
Procedure or Revenue Code
To specify identifying information
- This segment will convey service line or revenue code information that is associated with the additional information. This matches the value in the 837 SV101-2, SV201-2, or SV301-2 or the 277 SVC01-2 or SVC04.
- Required when the additional information is associated with the service line or revenue line information. If not required by this implementation guide, do not send.
Code qualifying the Reference Identification
- CPT
- Current Procedural Terminology Code
Used to convey the Procedure Code (HCPCS Level I (CPT) or Level II) reported in the 837 or the 277. Used to convey AMA CPT codes since they are considered Level I procedure codes.
See code source 130: Health Care Financing Administration Common Procedural Coding System
- F8
- Original Reference Number
Used to convey the Current Dental Terminology (CDT) code.
See code source 135: American Dental Association Codes.
- FO
- Drug Formulary Number
Used to convey the National Drug Code (NDC) in 5-4-2 format reported in the 837 or the 277.
See code source 240: National Drug Code by format.
- PRT
- Product Type
Used to convey HIEC codes.
The HIEC codes can only be used- if a new rule names the HIEC codes as an allowable code set under HIPAA.
- the Secretary grants an exception to use the code set as a pilot project under the law.
- for claims which are not covered under HIPAA.
See code source 513: Home Infusion EDI Coalition (HIEC)
- RB
- Rate code number
This code is used for Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility Rate Code.
- VP
- Vendor Product Number
This code is used for the Universal Product Number or when the 277 SVC01-1 has the value of UX.
This code set is not allowed for use under HIPAA at the time of this writing. The qualifier can only be used:
- If a new rule names the Universal Product Code as an allowable code set under HIPAA.
- For Property & Casualty claims/encounters that are not covered under HIPAA.
- YJ
- Revenue Source
Used to convey the Revenue Code reported in the 837 or the 277.
See code source 132: National Uniform Billing Committee (NUBC) Codes
- ZZ
- Mutually Defined
Used to convey Alternative Link codes.
See code source 843: Complementary, Alternative or Holistic Procedure Codes
The ABC codes may only be used
- in transactions covered under HIPAA by parties registered in the pilot project and their trading partners.
- if a new rule names the ABC code as an allowable code set under HIPAA.
- for claims which are not covered under HIPAA.
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
- When the service line item is identified with both a procedure code and a revenue code, the revenue code must be reported in REF04.
This element is required when the service line is identified with both a procedure code and a revenue code. If not required by this implementation guide, do not send.
Code qualifying the Reference Identification
- YJ
- Revenue Source
Used to convey the Revenue Code reported in the 837 or the 277.
See code source 132: National Uniform Billing Committee (NUBC) Codes
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Procedure Code Modifier
To specify identifying information
- Required when the procedure code submitted on the original claim include modifiers. If not required by this implementation guide, do not send.
- The procedure code modifiers should be reported in the same order as on the original claim.
Code qualifying the Reference Identification
- SK
- Service Change Number
Used to convey the procedure code modifier reported on the original claim.
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Required when the original claim includes more than 1 modifier. If not required by this implementation guide, do not send.
Code qualifying the Reference Identification
- XX4
- Object Code
Used to convey the procedure code modifier reported on the original claim.
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Code qualifying the Reference Identification
- 06
- System Number
Used to convey the procedure code modifier reported on the original claim.
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Code qualifying the Reference Identification
- 4N
- Special Payment Reference Number
Used to convey the procedure code modifier reported on the original claim.
Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Service Line Date of Service
To specify any or all of a date, a time, or a time period
- Required when the date of service is not reported at the claim level. If not required by this implementation guide, do not send.
Code specifying type of date or time, or both date and time
- 472
- Service
Code indicating the date format, time format, or date and time format
- DTP02 is the date or time or period format that will appear in DTP03.
- D8
- Date Expressed in Format CCYYMMDD
- RD8
- Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD
RD8 is required only when the To and From dates are different.
Expression of a date, a time, or range of dates, times or dates and times
Additional Information Submission Date
To specify any or all of a date, a time, or a time period
Code specifying type of date or time, or both date and time
- 368
- Submittal
Date information is submitted.
Code indicating the date format, time format, or date and time format
- DTP02 is the date or time or period format that will appear in DTP03.
- D8
- Date Expressed in Format CCYYMMDD
Expression of a date, a time, or range of dates, times or dates and times
Category of Patient Information Service
To specify categories of patient information service
Code indicating the title or contents of a document, report or supporting item
- AE
- Attachment
Code defining timing, transmission method or format by which reports are to be sent
- Code specifying the format of the HL7 CDA attachment information sent in BIN02. It is up to mutual agreement among trading partners what CAT02 value is used for attachment information not yet adopted or for a business process not addressed under HIPAA.
- HL
- Health Industry Level 7 Interface Standards (HL/7) Format
Specifies that the content of BIN02 is an HL7 CDA computer decision variant formatted according to HL7 specifications.
- IA
- Electronic Image
Specifies that the content of BIN02 is an electronic image. "IA" is never used when sending attachment information adopted under HIPAA.
"HL", "MB", or "TX" may be used for attachment information not adopted under HIPAA, and must be used when the attachment information is adopted.
- MB
- Binary Image
Specifies that the content of BIN02 is an HL7 CDA human decision non-XML variant formatted according to HL7 specifications.
- TX
- Text
Specifies that the content of BIN02 is an HL7 CDA human decision XML markup variant formatted according to HL7 specifications.
Revision level of a particular format, program, technique or algorithm
Electronic Format Identification
To provide basic information about the electronic format of the interchange data
Code indicating the level of confidentiality assigned by the sender to the information following
- 05
- Personal
Per public law publication 104-191 August 21, 1996 Section 1177 [HIPAA] - This information is confidential and wrongful use is subject to penalties.
Binary Data Segment
To transfer binary data in a single data segment and allow identification of the end of the data segment through a count; there is no identification of the internal structure of the binary data in this segment
- This segment is used to attach the data referenced in the CAT02 element.
The length in integral octets of the binary data
- Senders must ensure that the count in BIN01 is equal to the byte count of the contents in BIN02.
A string of octets which can assume any binary pattern from hexadecimal 00 to FF
- This element contains the HL7 CDA formatted attachment information as specified in CAT02. It is recommended that BIN02 not exceed 64 megabytes.
- The segment terminator used in the 275 transaction must not be used within the data content of BIN02.
- It has been noted that line constraints, transfer protocols, zip programs or conversion processes may insert additional control characters such as, line feeds or carriage returns or other special characters into a transaction. If this occurs in BIN02, the sender's stated count in BIN01 may no longer be equal to the received contents of the data in BIN02.
275 Transaction Set Trailer
To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)
Total number of segments included in a transaction set including ST and SE segments
- Do not include the segments contained within the HL7 format. The entire BIN segment is considered one segment in the count.
Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set
- The Transaction Set Control Number in ST02 and SE02 must be identical. The number is assigned by the originator and must be unique within a functional group (GS-GE). For example, start with the number 0001 and increment from there.
Functional Group Trailer
To indicate the end of a functional group and to provide control information
Total number of transaction sets included in the functional group or interchange (transmission) group terminated by the trailer containing this data element
Assigned number originated and maintained by the sender
Interchange Control Trailer
To define the end of an interchange of zero or more functional groups and interchange-related control segments
Example 1: Electronic Request
GS*PI*SENDERGS*RECEIVERGS*20240222*014254*000000001*X*005010X210~
ST*275*1001*005010X210~
BGN*11*0001*20060915~
NM1*PR*2*ABC INSURANCE COMPANY*****XV*12345~
NM1*41*2*XYZ SERVICES*****46*A222222221~
NM1*1P*2*ST HOLY HILLS HOSPITAL*****XX*3999000B01~
NX1*1P~
N3*2345 Winter Blvd~
N4*Miami*FL*33132~
NM1*QC*1*JACKSON*JACK*J***MI*987654320~
REF*EJ*JACKSON123~
REF*EA*STHHL12345~
DTP*472*D8*20060812~
LX*1~
TRN*2*1822634840~
STC*R4>18626-2>>LOI~
DTP*368*D8*20060915~
CAT*AE*TX~
EFI*05~
BIN*6*......~
LX*2~
TRN*2*1822634840~
STC*R4>18647-8>>LOI~
DTP*368*D8*20060915~
CAT*AE*TX~
EFI*05~
BIN*6*......~
SE*27*1001~
GE*1*000000001~
IEA*1*000000001~
Example 2: No 277 Request
GS*PI*SENDERGS*RECEIVERGS*20240222*014957*000000001*X*005010X210~
ST*275*1001*005010X210~
BGN*02*0001*20060918~
NM1*PR*2*ABC INSURANCE COMPANY*****XV*12345~
NM1*41*2*XYZ SERVICES*****46*A222222221~
NM1*1P*2*ST HOLY HILLS HOSPITAL*****XX*3999000801~
NX1*1P~
N3*2345 Winter Blvd~
N4*Miami*FL*33132~
NM1*QC*1*JACKSON*JACK*J***MI*987654323~
REF*EJ*JACKSON123~
REF*EA*STHHL12345~
DTP*472*D8*20060915~
LX*1~
TRN*1*986543~
DTP*368*D8*20060918~
CAT*AE*HL~
EFI*05~
BIN*4*1101~
SE*19*1001~
GE*1*000000001~
IEA*1*000000001~
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