Martin,
Re your interpretation of the usage requirement for the BHT03
element....you're on the mark. Even though it's an optional element IN THE
X12 STANDARD, it is REQUIRED by the HIPAA IG. Personally, I don't know why
the developers of the HIPAA IG's decided to use Required instead of the X12
Mandatory designator. I found it confusing. Oh well....
You will note in several instances that the HIPAA IG's will make the use of
a given construct REQUIRED even though it's an optional use construct in the
X12 standard.
To answer your last question....the HIPAA IG's have to not only reflect the
X12 standard but to specify their usage under HIPAA. That's what you'll see
the X12 optional designator shown, but overridden by either a not used,
required or situational usage indicator. I know this may seem confusing, but
as an EDI profesisonal I've always developed implementation guides showing
the full X12 standard as well as the implementer's use of the transaction.
This helps to keep folks "honest" in not deviating from the base underlying
X12 standard.
Good luck.
Rachel
Thanks, Rachel for the descriptions of the option attribute.
I'm all squared away on the "X" value now.
(Until we get to composites. I'll save that for a later discussion.)
Thanks also for confirming what I've always thought about codes "M" and "O"
as well.
An example of where the option attribute and the Industry Usage differ is in
TS-837.BHT.03.
I'm considering it a Required(Mandatory) element even though the option
attribute is "O".
Why wouldn't all REQUIRED elements reflect Option attribute "M"?
-----Original Message-----
From: Rachel Foerster [mailto:[EMAIL PROTECTED]]
Sent: Thursday, January 18, 2001 5:50 PM
To: [EMAIL PROTECTED]
Subject: Re: HIPAA vs: Standard Implementation Usage
Identifiers/Attributes
Martin,
The the X12 standards for the segment definition under the attributes
column, M= Mandatory, O=Optional, and X is an indicator telling the reader
there is a syntax note providing further information about the use of that
particular element in the segment. What you should then do is note the
ordinal position of the element in question (marked with an X under
Requirement Designator and then locate the associated syntaxt note for the
precise usage of that element in the segment. Quite often you'll find that
the syntax note further defines some type of conditional relationship, such
as paired, relational, list, exclusion, and so on. The X is the mechanism
used in the X12 standards to point the reader to such notes. Your EDI
translator should enforce this syntactic requirement through programming
logic.
In some segments you could see this: X/Z. This tells the reader that not
only is there a syntax note for the element but also a Semantic note or
comment which further defines the element.
In all cases, don't ignore such notes; they are part of the X12 standard and
cannot be ignored.
In the HIPAA IG's the X still points you to a synatax note. But the note is
found in the beginning part of the segment definition. For example, the NM1
segment, NM109 element has a syntax note defining a relationship with the
NM108 element. The only difference between the HIPAA IG's and the X12
standards is the style of presentation of the information.
Hope this helps. If not, would you please point me to a specific segment in
both the HIPAA IG and the X12 Standard and perhaps I can try explaining it
further.
Rachel
I'm not having a problem with the "REQUIRED"/"SITUATIONAL"/"NOT USED" HIPAA
Industry Usages.
Again, it's the values in the first column of ATTRIBUTES in the HIPAA IG's
that's unclear to me.
What was the "Option" attribute in 4010 standard implementations, appears to
be called "Requirement Designator" in the HIPAA IG's (according to the
Diagram Segment Key).
Is there a definition for the values found there ("M", "O" and "X")?
-----Original Message-----
From: Rachel Foerster [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, January 17, 2001 5:47 PM
To: [EMAIL PROTECTED]
Subject: Re: HIPAA vs: Standard Implementation Usage
Identifiers/Attributes
Martin,
There are NO optional use segments, elements or codes in HIPAA. Here's the
way to read the HIPAA IGs:
Not used. Do NOT use this element.
Situational. Read the BOLD print to determine in which situations the
segment, element or code becomes either required or not used.
Required. You MUST use this element.
Additionally, since in the X12 standards (on which the HIPAA standards are
based) there are some elements that have conditional relationships to other
elements, these conditional relationships must be complied with. Thus, if an
element is situational, read the bold print very carefully to determine
whether or not the situation applies in your case and then if it does, and
the element also has a conditional relationship with another, you must also
use that other element. Most often, the conditionality is between an element
containing coded data and a qualifier which gives meaning to the coded data.
Don't become confused by trying to bring in to your analysis the X12 usage
requirements of Mandatory, Optional. As stated above, there are NO OPTIONAL
use segments, elements or codes in HIPAA.
Hope this helps.
Rachel
I thought I had all this down, but now fear that I'm losing my grasp on
these redefined values.
Loop/Segment/Element usage:
Standard 4010;
[C]onditional
[M]andatory
[O]ptional
HIPAA;
[N]ot Used
[R]equired
[S]ituational
Element Option (Requirement Designator) Attributes:
Standard 4010;
[C]onditional
[M]andatory
[O]ptional
HIPAA;
[M]andatory???
[O]ptional???
[X]Conditional/Situational???
There is a flaw in my understanding of the relationship between the usage
and option attributes.
What do these codes [M], [O] and [X] really represent?
Elements marked REQUIRED use all three codes.
Martin A. Morrison
Project Lead
HIPAA Implemention/Coordination
Blue Shield of California
80 Blue Ravine Rd.
Folsom, Ca 95630
(916) 350-8808
mailto:[EMAIL PROTECTED]
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