SOURCE: ASC X12

ASC X12

April 22, 2013 13:06 ET

Announcing a Public Review Period for a Revision to the ASC X12 Technical Report Type 2: Code Value Usage in Health Care Claim Payments and Subsequent Claims

FALLS CHURCH, VA--(Marketwired - Apr 22, 2013) - A revision to the ASC X12 Code Value Usage in Health Care Claim Payments and Subsequent Claims Technical Report Type 2 is now available for industry review. This revision has been developed by ASC X12N TG2 WG3, which is the Claim Payments work group within the Health Care task group of the Insurance Subcommittee of X12. X12 is an Accredited Standards Committee (ASC) under the American National Standards Institute (ANSI).

The purpose of this technical report is to present code usage rules for three code sets used in the Health Care Claim Payment/Advice (835). These code sets are:

  • Claim Adjustment Group Codes, published in ASC X12 Health Care Claim Payment/Advice (835) Technical Report Type 3 (005010X221 and errata 005010X221A1)
  • Claim Adjustment Reason Codes (CARCs), available at www.wpc-edi.com
  • Remittance Advice Remark Codes (RARCs), available at www.wpc-edi.com

The TR2 was developed to foster standard code use by presenting the valid combinations of these code sets. These usage rules may be applied to 005010 and 006020 versions of the 835 TR3 but are not mandated for use at this time.

This TR2 incorporates a revised structure in addition to all code changes made by the committees that maintain the CARCs and RARCs through January 2013.

The public review period will commence April 17, 2013 and will close on May 17, 2013 at 5:00 PM Pacific Time.

The work group will consider all comments submitted during the public review period. Official responses will be posted to the on-line conference 15 days prior to the corresponding Informational Forum. The posted response is not necessarily the final determination. Additional discussion in the Informational Forum may result in the work group approving a modification to the posted response. Such modifications are not posted to the on-line conference.

This is the only public review period. For a complete understanding of changes being suggested and/or made to the technical report, reviewers should monitor the on-line conference during the public review period and consider all developer responses prior to the Informational Forum.

Watch for the announcement of the corresponding Informational Forum. The Informational Forum is the final opportunity to comment on modifications based on the public review comments.

The draft update to the Technical report Type 2 is available for download at: http://forums.x12.org

Comments on the draft Update can be submitted via the on-line conference at: http://forums.x12.org

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