You may need to check the status of a claim if you don’t receive a 277CA or 835 ERA response from the payer within your expected timeframe. You may also want to check the status of a claim submitted by another entity. For example, a billing agency may want to check the status of a claim submitted by their customer, who is a provider.
Used in the serviceLineInformation.productOrServiceIDQualifier request property and the claims.serviceDetails.service.serviceIdQualifierCode property in the response.
Code
Description
Usage Notes
AD
American Dental Association Codes
-
ER
Jurisdiction Specific Procedure and Supply Codes
This code is not allowed for use under HIPAA. The qualifier can only be used when 1) If a new rule names the Jurisdiction Specific Procedure and Supply Codes as an allowable code set under HIPAA, OR 2) The Secretary grants an exception to use the code set as a pilot project as allowed under the law, OR 3) For claims that aren’t covered under HIPAA.
HC
Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes
Because the CPT codes of the American Medical Association are also level 1 HCPCS codes, the CPT codes are reported under the code HC.
HP
Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility Rate Code
-
IV
Home Infusion EDI Coalition (HIEC) Product/Service Code
This code is not allowed for use under HIPAA. The qualifier can only be used when 1) If a new rule names the Home Infusion EDI Coalition Codes as an allowable code set under HIPAA, OR 2) The Secretary grants an exception to use the code set as a pilot project as allowed under the law, OR 3) For claims that aren’t covered under HIPAA.
N4
National Drug Code in 5-4-2 Format
-
NU
National Uniform Billing Committee (NUBC) UB92 Codes
This code is the NUBC Revenue Code.
WK
Advanced Billing Concepts (ABC) Codes
This code set has been approved by the Secretary of HHS as a pilot project allowed under HIPAA law. The qualifier may only be used in transactions covered under HIPAA; by parties registered in the pilot project and their trading partners, OR when a new rule names the Complementary, Alternative, or Holistic Procedure Codes as an allowable code set under HIPAA, OR for claims that aren’t covered under HIPAA.
