Chiapas EDI 2012 Mapping Guide

(C) Copyright 2012 Chiapas EDI Technologies, Inc.

5010_276 5010 Health Care Claim Status Request - Code:O0

ISA - GROUP HEADERS

LoopSegmentSegment NameChiapas Gate Mapping
OEISAISAInterchange Control Header
OEISAISA02No Authorization Information PresentOEISA_S01_ISA02_AUTH_NFO_OVL_NO_AUTH_NFO
OEISAISA02Additional Data IdentificationOEISA_S01_ISA02_AUTH_NFO_OVL_ADDL_ID
OEISAISA04No Security Information PresentOEISA_S01_ISA04_SEC_NFO_OVL_NO_SEC_NFO
OEISAISA04PasswordOEISA_S01_ISA04_SEC_NFO_OVL_PASSWD
OEISAISA06Dun and BrandstreetOEISA_S01_ISA06_SENDR_ID_OVL_DUNS_ID
OEISAISA06Duns Plus SuffixOEISA_S01_ISA06_SENDR_ID_OVL_DUNS_SUFFX_ID
OEISAISA06Health Industry NumberOEISA_S01_ISA06_SENDR_ID_OVL_HIN_ID
OEISAISA06Carrier Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA06_SENDR_ID_OVL_HCFA_CARR_ID
OEISAISA06Fiscal Intermediary Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA06_SENDR_ID_OVL_HCFA_FIIN_ID
OEISAISA06Medicare Provider and Supplier Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA06_SENDR_ID_OVL_HCFA_MEDCR_ID
OEISAISA06US Federal Tax Identification NumberOEISA_S01_ISA06_SENDR_ID_OVL_TAX_ID
OEISAISA06National Association of Insurance Commissioners Company CodeOEISA_S01_ISA06_SENDR_ID_OVL_NAIC_ID
OEISAISA06Mutually DefinedOEISA_S01_ISA06_SENDR_ID_OVL_MUTLY_DEFND_ID
OEISAISA08Dun and BrandstreetOEISA_S01_ISA08_RECVR_ID_OVL_DUNS_ID
OEISAISA08Duns Plus SuffixOEISA_S01_ISA08_RECVR_ID_OVL_DUNS_SUFFX_ID
OEISAISA08Health Industry NumberOEISA_S01_ISA08_RECVR_ID_OVL_HIN_ID
OEISAISA08Carrier Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA08_RECVR_ID_OVL_HCFA_CARR_ID
OEISAISA08Fiscal Intermediary Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA08_RECVR_ID_OVL_HCFA_FIIN_ID
OEISAISA08Medicare Provider and Supplier Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA08_RECVR_ID_OVL_HCFA_MEDCR_ID
OEISAISA08US Federal Tax Identification NumberOEISA_S01_ISA08_RECVR_ID_OVL_TAX_ID
OEISAISA08National Association of Insurance Commissioners Company CodeOEISA_S01_ISA08_RECVR_ID_OVL_NAIC_ID
OEISAISA08Mutually DefinedOEISA_S01_ISA08_RECVR_ID_OVL_MUTLY_DEFND_ID
OEISAISA09Interchange DateOEISA_S01_ISA09_DT
OEISAISA10Interchange TimeOEISA_S01_ISA10_TM
OEISAISA11Repetition SeparatorOEISA_S01_ISA11_REPTN_SEPRTR
OEISAISA12Interchang Control Version NumberOEISA_S01_ISA12_VERSN_NR
OEISAISA13Interchange Control NumberOEISA_S01_ISA13_ICN
OEISAISA14Acknowledgment RequestedOEISA_S01_ISA14_ACK_REQ
OEISAISA15Interchange Usage IndicatorOEISA_S01_ISA15_USG_IND
OEISAISA16Component Element SeparatorOEISA_S01_ISA16_SUBELE_SEP
OEISAIEAInterchange Control Trailer
OEISAIEA01Number of Included Functional GroupsOEISA_S03_IEA01_GS_CT
OEISAIEA02Interchange Control NumberOEISA_S03_IEA02_ICN

GSHDR - GROUP HEADER

LoopSegmentSegment NameChiapas Gate Mapping
GSHDRGSFunctional Group Header
GSHDRGS01Functional Identifier CodeGSHDR_S01_GS01_FUNCTL_ID_CD
GSHDRGS02Application Senders CodeGSHDR_S01_GS02_APP_SENDR_CD
GSHDRGS03Application Receivers CodeGSHDR_S01_GS03_APP_RECVR_CD
GSHDRGS04DateGSHDR_S01_GS04_DT
GSHDRGS05TimeGSHDR_S01_GS05_TM
GSHDRGS06Group Control NumberGSHDR_S01_GS06_GCN
GSHDRGS07Responsible Agency CodeGSHDR_S01_GS07_RESP_AGNCY_CD
GSHDRGEFunctional Group Trailer
GSHDRGE01Number of Transaction Sets IncludedGSHDR_S03_GE01_TS_CT
GSHDRGE02Group Control NumberGSHDR_S03_GE02_GCN

STHDR - TRANSACTION SET HEADER

LoopSegmentSegment NameChiapas Gate Mapping
STHDRSTTransaction Set Header
STHDRST01Transaction Set Identifier CodeSTHDR_S01_ST01_ID_CD
STHDRST02Transaction Set Control NumberSTHDR_S01_ST02_CONTRL_NR
STHDRST03Version, Release, or Industry IdentifierSTHDR_S01_ST03_VERS_RELS_INDSTRY_ID
STHDRBHTBeginning of Hierarchical Transaction
STHDRBHT01Hierarchical Structure CodeSTHDR_S02_BHT01_STRUCTR_CD
STHDRBHT02Transaction Set Purpose CodeSTHDR_S02_BHT02_TS_PURPS_CD
STHDRBHT03Reference IdentificationSTHDR_S02_BHT03_REF_ID
STHDRBHT04Transaction Set Creation DateSTHDR_S02_BHT04_TS_CREATN_DT
STHDRBHT05Transaction Set Creation TimeSTHDR_S02_BHT05_TS_CREATN_TIM
STHDRSETransaction Set Trailer
STHDRSE01Transaction Segment CountSTHDR_S04_SE01_SEG_CT
STHDRSE02Transaction Set Control NumberSTHDR_S04_SE02_TCN

2000A - INFORMATION SOURCE LEVEL

LoopSegmentSegment NameChiapas Gate Mapping
L2000AHLInformation Source Level
L2000AHL01Hierarchical ID NumberL2000A_S01_HL01_HIERCHCL_ID_NR
L2000AHL04Hierarchical Child CodeL2000A_S01_HL04_HIERCHCL_CHILD_CD

2100A - PAYER NAME

LoopSegmentSegment NameChiapas Gate Mapping
L2100ANM1Payer Name
L2100ANM103Non-Person EntityL2100A_S01_NM103_PAYR_NM_OVL_NONPRSN_ENTY
L2100ANM109Payor IdentificationL2100A_S01_NM109_PAYR_ID_OVL_PAYR_ID
L2100ANM109Centers for Medicare and Medicaid Services PlanIDL2100A_S01_NM109_PAYR_ID_OVL_MDCR_MDCD_SVCS_PLAND

2000B - INFORMATION RECEIVER LEVEL

LoopSegmentSegment NameChiapas Gate Mapping
L2000BHLInformation Receiver Level
L2000BHL01Hierarchical ID NumberL2000B_S01_HL01_HIERCHCL_ID_NR
L2000BHL02Hierarchical Parent ID NumberL2000B_S01_HL02_HIERCHCL_PARNT_ID_NR
L2000BHL04Hierarchical Child CodeL2000B_S01_HL04_HIERCHCL_CHILD_CD

2100B - INFORMATION RECEIVER NAME

LoopSegmentSegment NameChiapas Gate Mapping
L2100BNM1Information Receiver Name
L2100BNM102Entity Type QualifierL2100B_S01_NM102_ENTY_TYPE_QUAL
L2100BNM103Information Receiver Last or Organization NameL2100B_S01_NM103_NFO_RECVR_LAST_ORG_NM
L2100BNM104Information Receiver First NameL2100B_S01_NM104_NFO_RECVR_FNAME
L2100BNM105Information Receiver Middle NameL2100B_S01_NM105_NFO_RECVR_MNAME
L2100BNM109Electronic Transmitter Identification Number (ETIN)L2100B_S01_NM109_NFO_RECVR_ID_NR_OVL_ETN_NR

2000C - SERVICE PROVIDER LEVEL

LoopSegmentSegment NameChiapas Gate Mapping
L2000CHLService Provider Level
L2000CHL01Hierarchical ID NumberL2000C_S01_HL01_HIERCHCL_ID_NR
L2000CHL02Hierarchical Parent ID NumberL2000C_S01_HL02_HIERCHCL_PARNT_ID_NR
L2000CHL04Hierarchical Child CodeL2000C_S01_HL04_HIERCHCL_CHILD_CD

2100C - PROVIDER NAME

LoopSegmentSegment NameChiapas Gate Mapping
L2100CNM1Provider Name
L2100CNM102Entity Type QualifierL2100C_S01_NM102_ENTY_TYPE_QUAL
L2100CNM103Provider Last or Organization NameL2100C_S01_NM103_PROV_LAST_ORG_NM
L2100CNM104Provider First NameL2100C_S01_NM104_PROV_FNAME
L2100CNM105Provider Middle NameL2100C_S01_NM105_PROV_MNAME
L2100CNM107Provider Name SuffixL2100C_S01_NM107_NM_SUFX
L2100CNM109Federal Taxpayer’s Identification NumberL2100C_S01_NM109_PROV_ID_OVL_FED_TAX_ID_NR
L2100CNM109Service Provider NumberL2100C_S01_NM109_PROV_ID_OVL_SVC_PROV_NR
L2100CNM109Centers for Medicare and Medicaid Services National Provider IdentifierL2100C_S01_NM109_PROV_ID_OVL_MDCR_MDCD_SVCS_NATNL_PROV_ID

2000D - SUBSCRIBER LEVEL

LoopSegmentSegment NameChiapas Gate Mapping
L2000DHLSubscriber Level
L2000DHL01Hierarchical ID NumberL2000D_S01_HL01_HIERCHCL_ID_NR
L2000DHL02Hierarchical Parent ID NumberL2000D_S01_HL02_HIERCHCL_PARNT_ID_NR
L2000DHL04Hierarchical Child CodeL2000D_S01_HL04_HIERCHCL_CHILD_CD
L2000DDMGSubscriber Demographic Information
L2000DDMG02Date Expressed in Format CCYYMMDDL2000D_S02_DMG02_BIRTH_DT_OVL_DT_CCYYMMDD
L2000DDMG03Subscriber Gender CodeL2000D_S02_DMG03_GENDR_CD

2100D - SUBSCRIBER NAME

LoopSegmentSegment NameChiapas Gate Mapping
L2100DNM1Subscriber Name
L2100DNM103PersonL2100D_S01_NM103_SUB_LNAME_OVL_PERSN
L2100DNM103Non-Person EntityL2100D_S01_NM103_SUB_LNAME_OVL_NONPRSN_ENTY
L2100DNM104Subscriber First NameL2100D_S01_NM104_SUB_FNAME
L2100DNM105Subscriber Middle Name or InitialL2100D_S01_NM105_MNAME_INTL
L2100DNM107Subscriber Name SuffixL2100D_S01_NM107_NM_SUFX
L2100DNM109Employer’s Identification NumberL2100D_S01_NM109_SUB_ID_OVL_EMPLYR_ID_NR
L2100DNM109Standard Unique Health Identifier for each Individual in the United StatesL2100D_S01_NM109_SUB_ID_OVL_STANDRD_UNQ_HEALTH_ID
L2100DNM109Member Identification NumberL2100D_S01_NM109_SUB_ID_OVL_MEM_ID_NR

2200D - CLAIM STATUS TRACKING NUMBER

LoopSegmentSegment NameChiapas Gate Mapping
L2200DTRNClaim Status Tracking Number
L2200DTRN01Trace Type CodeL2200D_S01_TRN01_TYPE_CD
L2200DTRN02Current Transaction Trace NumberL2200D_S01_TRN02_CURNT_TRANSCTN_TRAC_NR
L2200DREFPayer Claim Control Number
L2200DREF02Payor’s Claim NumberL2200D_S02_REF02_PAYR_CLM_CONTRL_NR_OVL_PAYR_CLM_NR
L2200DREFInstitutional Bill Type Identification
L2200DREF02Billing TypeL2200D_S03_REF02_TYPE_ID_OVL_BILNG_TYPE
L2200DREFApplication or Location System Identifier
L2200DREF02Location NumberL2200D_S04_REF02_APLCTN_LOC_SYS_ID_OVL_LOC_NR
L2200DREFGroup Number
L2200DREF02Group NumberL2200D_S05_REF02_GRP_NR_OVL_GRP_NR
L2200DREFPatient Control Number
L2200DREF02Patient Account NumberL2200D_S06_REF02_CONTRL_NR_OVL_PATNT_ACNT_NR
L2200DREFPharmacy Prescription Number
L2200DREF02Pharmacy Prescription NumberL2200D_S07_REF02_RX_NR_OVL_PHARMCY_RX_NR
L2200DREFClaim Identification Number For Clearinghouses and Other Transmission Intermediaries
L2200DREF02Claim NumberL2200D_S08_REF02_TRAC_NR_OVL_CLM_NR
L2200DAMTClaim Submitted Charges
L2200DAMT02Total Submitted ChargesL2200D_S09_AMT02_TOTL_CLM_CHG_AMT_OVL_TOTL_SUBMTD_CHGS
L2200DDTPClaim Service Date
L2200DDTP03Service (D8)L2200D_S10_DTP03_SVC_PERD_OVL_SVC_D8
L2200DDTP03Service (RD8)L2200D_S10_DTP03_SVC_PERD_OVL_SVC_RD8

2210D - SERVICE LINE INFORMATION

LoopSegmentSegment NameChiapas Gate Mapping
L2210DSVCService Line Information
L2210DSVC01-02American Dental Association CodesL2210D_S01_SVC01_02_PROC_CD_OVL_AMRCN_DENTL_ASCTN_CD
L2210DSVC01-02Jurisdiction Specific Procedure and Supply CodesL2210D_S01_SVC01_02_PROC_CD_OVL_JURSDCTN_SPECFC_PROC_SUPLY_CD
L2210DSVC01-02Health Care Financing Administration Common Procedural Coding System (HCPCS) CodesL2210D_S01_SVC01_02_PROC_CD_OVL_HCPCS_CD
L2210DSVC01-02Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility Rate CodeL2210D_S01_SVC01_02_PROC_CD_OVL_HIPPS_SNIF_RAT
L2210DSVC01-02Home Infusion EDI Coalition (HIEC) Product/ServiceL2210D_S01_SVC01_02_PROC_CD_OVL_HIEC_PRODCT_SRVC
L2210DSVC01-02National Drug Code in 5-4-2 FormatL2210D_S01_SVC01_02_PROC_CD_OVL_NDC_542_FORMT
L2210DSVC01-02National Uniform Billing Committee (NUBC) UB92L2210D_S01_SVC01_02_PROC_CD_OVL_NUBC_UB92
L2210DSVC01-02Advanced Billing Concepts (ABC) CodesL2210D_S01_SVC01_02_PROC_CD_OVL_ABC_CD
L2210DSVC01-03Procedure ModifierL2210D_S01_SVC01_03_PROC_MODFR
L2210DSVC01-04Procedure ModifierL2210D_S01_SVC01_04_PROC_MODFR
L2210DSVC01-05Procedure ModifierL2210D_S01_SVC01_05_PROC_MODFR
L2210DSVC01-06Procedure ModifierL2210D_S01_SVC01_06_PROC_MODFR
L2210DSVC02Line Item Charge AmountL2210D_S01_SVC02_LIN_ITM_CHG_AMT
L2210DSVC04Revenue CodeL2210D_S01_SVC04_REVN_CD
L2210DSVC07Units of Service CountL2210D_S01_SVC07_UNTS_SVC_CT
L2210DREFService Line Item Identification
L2210DREF02Line Item Control NumberL2210D_S02_REF02_LIN_ITM_CONTRL_NR_OVL_LIN_ITM_CONTRL_NR
L2210DDTPService Line Date
L2210DDTP03Service (D8)L2210D_S03_DTP03_SVC_LIN_DT_OVL_SVC_D8
L2210DDTP03Service (RD8)L2210D_S03_DTP03_SVC_LIN_DT_OVL_SVC_RD8

2000E - DEPENDENT LEVEL

LoopSegmentSegment NameChiapas Gate Mapping
L2000EHLDependent Level
L2000EHL01Hierarchical ID NumberL2000E_S01_HL01_HIERCHCL_ID_NR
L2000EHL02Hierarchical Parent ID NumberL2000E_S01_HL02_HIERCHCL_PARNT_ID_NR
L2000EDMGDependent Demographic Information
L2000EDMG02Date Expressed in Format CCYYMMDDL2000E_S02_DMG02_PATNT_BIRTH_DT_OVL_DT_CCYYMMDD
L2000EDMG03Patient Gender CodeL2000E_S02_DMG03_PATNT_GENDR_CD

2100E - DEPENDENT NAME

LoopSegmentSegment NameChiapas Gate Mapping
L2100ENM1Dependent Name
L2100ENM103PersonL2100E_S01_NM103_PATNT_LNAME_OVL_PERSN
L2100ENM104Patient First NameL2100E_S01_NM104_PATNT_FNAME
L2100ENM105Patient Middle Name or InitialL2100E_S01_NM105_PATNT_MNAME_INTL
L2100ENM107Patient Name SuffixL2100E_S01_NM107_PATNT_NM_SUFX

2200E - CLAIM STATUS TRACKING NUMBER

LoopSegmentSegment NameChiapas Gate Mapping
L2200ETRNClaim Status Tracking Number
L2200ETRN01Trace Type CodeL2200E_S01_TRN01_TYPE_CD
L2200ETRN02Current Transaction Trace NumberL2200E_S01_TRN02_CURNT_TRANSCTN_TRAC_NR
L2200EREFPayer Claim Control Number
L2200EREF02Payor’s Claim NumberL2200E_S02_REF02_PAYR_CLM_CONTRL_NR_OVL_PAYR_CLM_NR
L2200EREFInstitutional Bill Type Identification
L2200EREF02Billing TypeL2200E_S03_REF02_TYPE_ID_OVL_BILNG_TYPE
L2200EREFApplication or Location System Identifier
L2200EREF02Location NumberL2200E_S04_REF02_APLCTN_LOC_SYS_ID_OVL_LOC_NR
L2200EREFGroup Number
L2200EREF02Group NumberL2200E_S05_REF02_GRP_NR_OVL_GRP_NR
L2200EREFPatient Control Number
L2200EREF02Patient Account NumberL2200E_S06_REF02_CONTRL_NR_OVL_PATNT_ACNT_NR
L2200EREFPharmacy Prescription Number
L2200EREF02Pharmacy Prescription NumberL2200E_S07_REF02_RX_NR_OVL_PHARMCY_RX_NR
L2200EREFClaim Identification Number For Clearinghouses and Other Transmission Intermediaries
L2200EREF02Claim NumberL2200E_S08_REF02_TRAC_NR_OVL_CLM_NR
L2200EAMTClaim Submitted Charges
L2200EAMT02Total Submitted ChargesL2200E_S09_AMT02_TOTL_CLM_CHG_AMT_OVL_TOTL_SUBMTD_CHGS
L2200EDTPClaim Service Date
L2200EDTP03Service (D8)L2200E_S10_DTP03_SVC_PERD_OVL_SVC_D8
L2200EDTP03Service (RD8)L2200E_S10_DTP03_SVC_PERD_OVL_SVC_RD8

2210E - SERVICE LINE INFORMATION

LoopSegmentSegment NameChiapas Gate Mapping
L2210ESVCService Line Information
L2210ESVC01-02American Dental Association CodesL2210E_S01_SVC01_02_PROC_CD_OVL_AMRCN_DENTL_ASCTN_CD
L2210ESVC01-02Jurisdiction Specific Procedure and Supply CodesL2210E_S01_SVC01_02_PROC_CD_OVL_JURSDCTN_SPECFC_PROC_SUPLY_CD
L2210ESVC01-02Health Care Financing Administration Common Procedural Coding System (HCPCS) CodesL2210E_S01_SVC01_02_PROC_CD_OVL_HCPCS_CD
L2210ESVC01-02Health Insurance Prospective Payment System (HIPPS) Skilled Nursing Facility Rate CodeL2210E_S01_SVC01_02_PROC_CD_OVL_HIPPS_SNIF_RAT
L2210ESVC01-02Home Infusion EDI Coalition (HIEC) Product/ServiceL2210E_S01_SVC01_02_PROC_CD_OVL_HIEC_PRODCT_SRVC
L2210ESVC01-02National Drug Code in 5-4-2 FormatL2210E_S01_SVC01_02_PROC_CD_OVL_NDC_542_FORMT
L2210ESVC01-02National Uniform Billing Committee (NUBC) UB92L2210E_S01_SVC01_02_PROC_CD_OVL_NUBC_UB92
L2210ESVC01-02Advanced Billing Concepts (ABC) CodesL2210E_S01_SVC01_02_PROC_CD_OVL_ABC_CD
L2210ESVC01-03Procedure ModifierL2210E_S01_SVC01_03_PROC_MODFR
L2210ESVC01-04Procedure ModifierL2210E_S01_SVC01_04_PROC_MODFR
L2210ESVC01-05Procedure ModifierL2210E_S01_SVC01_05_PROC_MODFR
L2210ESVC01-06Procedure ModifierL2210E_S01_SVC01_06_PROC_MODFR
L2210ESVC02Line Item Charge AmountL2210E_S01_SVC02_LIN_ITM_CHG_AMT
L2210ESVC04Revenue CodeL2210E_S01_SVC04_REVN_CD
L2210ESVC07Units of Service CountL2210E_S01_SVC07_UNTS_SVC_CT
L2210EREFService Line Item Identification
L2210EREF02Line Item Control NumberL2210E_S02_REF02_LIN_ITM_CONTRL_NR_OVL_LIN_ITM_CONTRL_NR
L2210EDTPService Line Date
L2210EDTP03Service (D8)L2210E_S03_DTP03_SVC_LIN_DT_OVL_SVC_D8
L2210EDTP03Service (RD8)L2210E_S03_DTP03_SVC_LIN_DT_OVL_SVC_RD8