Healthcare Guidelines Non-HIPAA Mandated
|
|
Document Name |
EDISIM **
Types 1-2 |
HIPAA Validator Desktop or Instream
*Types 1-2 |
HIPAA Validator Desktop or Instream
No SVALU Records
Types 1-7 |
GuidelinePlus Instream only
DS, RG, TI Types 1-7 Types 1-2 |
(www.wpc-edi.com)
|
Value in GS08
|
|---|---|---|---|---|---|---|---|
|
275 |
Health Care Claim or Encounter |
275-X314 |
275-X314 |
6020-275X314 |
PDSA6020-275X314 PDSX6020-275X314 |
275-X314-6020.pdf |
006020X314 |
|
275 |
Health Care Services Review |
275-X316 |
275-X316 |
6020-275X316 |
PDSA6020-275X316 PDSX6020-275X316 |
275-X316-6020.pdf |
006020X316 |
|
277 |
Health Care Claim Pending Status Information |
277-X228 |
277-X228 |
n/a |
PDSX5010-277X228
|
277-X228-5010.pdf |
005010X228 |
|
277 |
Health Care Claim Request for Additional Information (277) |
277-X213 |
277-X213 |
n/a |
PDSX5010-277X213 |
277-X213-5010.pdf |
005010X213 |
|
277 |
Health Care Claim Request for Additional Information |
277-X313 |
277-X313 |
6020-277X313 |
PDSA6020-277X313 PDSX6020-277X313 |
277-X313-6020.pdf |
006020X313 |
|
277 |
Data Reporting Acknowledgment |
277-X364 |
277-X364 |
5010-277DRAX364 |
PDSA5010277DRAX364 |
277-X364-5010.pdf |
005010X364 |
|
278 |
Health Care Services Review Information - Inquiry |
278X215I |
278X215I |
5010-278X215I |
PDSA5010-278X215I PDSX5010-278X215I |
278-X215I-5010.pdf |
005010X215 |
|
278 |
Health Care Services Review Information - Response |
278X215R |
278X215R |
5010-278X215R |
PDSA5010-278X215R PDSX5010-278X215R |
278-X215R-5010.pdf |
005010X215 |
|
278 |
Health Care Services Review Information - Acknowledgement |
278X216A |
278X216A |
5010-278X216A |
PDSA5010-278X216A PDSX5010-278X216A |
278-X216A-5010.pdf |
005010X216 |
|
278 |
Health Care Services Review Information - Notification |
278X216N |
278X216N |
5010-278X216N |
PDSA5010-278X216N PDSX5010-278X216N |
278-X216N-5010.pdf |
005010X216 |
|
820 |
Health Insurance Exchange: Related Payment |
820-X306 |
820-X306 |
5010-820X306 |
PDSA5010-820X306 PDSX5010-820X306 |
820-x306-5010.pdf |
005010X306
|
|
820 |
Health Insurance Exchange: Related Payment (CMS Companion Guideline) |
n/a |
820-X306 |
5010-HIX-820X306 |
PDSA5010HIX-820X306 |
No PDF |
005010X306 |
|
834 |
Benefit Enrollment And Maintenance: Health Care Exchange (CMS Companion Guideline) |
n/a |
834-X220 |
5010-HIX-834X220 |
PDSA5010HIX-834X220 |
No PDF
|
005010X220A1 |
|
834 |
Health Insurance Exchange: Enrollment |
834-X307 |
834-X307 |
5010-834X307 |
PDSA5010-834X307 PDSX5010-834X307 |
834-x307-5010.pdf |
005010X307 |
|
834 |
Plan Member Reporting |
834-X318 |
834-X318 |
5010-834X318 |
PDSA5010-834X318 PDSX5010-834X318 |
834-x318-5010.pdf |
005010X318 |
|
837D |
Dental, Post-Adjudication Claims Data Reporting |
837-X300 |
837-X300 |
5010-837X300 |
PDSA5010-837X300 PDSX5010-837X300 |
837-x300-5010.pdf |
005010X300
|
|
837I |
Institutional, Post- Adjudication Claims Data Reporting |
837-X299 |
837-X299 |
5010-837X299 |
PDSA5010-837X299 PDSX5010-837X299 |
837-x299-5010.pdf |
005010X299 |
|
837P |
Professional, PostAdjudication Claims Data Reporting |
837-X298 |
837-X298 |
5010-837X298 |
PDSA5010-837X298 PDSX5010-837X298 |
837-x298-5010.pdf |
005010X298 |
|
997 |
Functional Acknowledgment |
5010-997 |
5010-997 |
n/a |
n/a PDSX5010997 |
No PDF
|
005010 |
|
999 |
Implementation Acknowledgment |
999-X231 |
999-X231 |
5010-999X231 |
PDSA5010-999X231 PDSX5010-999X231 |
999_X231.pdf |
005010 005010X231 |