Kepa, While it would nice to get an interpretation from X12C Communications & Controls Subcommittee, my personal opinion is that this guidance would come much too late to be of use to those who are implementing now. Rather, I would strongly encourage the WEDi SNIP Transactions Work Group to take the lead and offer guidance. Further, my recommendations would be that the preferred or recommended sequencing and grouping be as the various HL loops are currently presented in the various HIPAA IGs. That is, that the various high-level context start followed by the next logical contextual level. For example, in the 837 Institutional the several contextual levels are:
Billing/Pay-to Provider Subscriber Patient These contextual levels provide a logical grouping and nesting. I further believe that this is the logical grouping or linking that would be found in most application systems as well. I do not think that it would be logical to create an 837 Institutional containing multiple Billing/Pay-to Providers, multiple subscribers, and multiple patients to sequence all of the HL loops for all Billing/Pay-to Providers first followed by all of the HL loops for all subscribers (and then have to logically link the subscriber HL to the correct Billing/Pay-to Provider HL, and then to sequence all of the HL loops for all Patients and have to logically link each Patient HL to its logical Subscriber parent HL. While technically this is achievable, it is counterintuitive. While the X12 standards are silent on how to actually sequence multiple HL loops with their various contextual levels, I think that the logical grouping and sequencing is more consistent with today's application systems logical grouping and linking, whether in today's relational database management systems or in the old IBM IMS parent/child dbms. Taking the logical grouping approach is also preferable in my opinion since not all commercially available EDI translators have the flexible mapping capabilities to manage the appropriate HL01 Hierarchical ID number assignment **and** the logical linking and assignment of parent Hierarchical IDs to subsequent child HL loops in HL02 that do not immediately follow the parent HL loop construct. I also agree with William that the **top/down, left/right** hierarchical concept does lend guidance to implementers. So, my strong recommendation is for the WEDi SNIP Transactions Work Group to bite the bullet and make this implementation recommendation **now** to the industry. Personally, even if an interpretation of sequencing and grouping was requested of X12C, that request could only first be presented to X12C at the February 2002 meeting in Seattle. And even in the most optimistic of timelines and assuming that X12C could write and approve such an interpretation at the February trimester meeting, the dissemination of that guidance would come much too late for implementers. The industry needs guidance now and I think it's very appropriate for the Transactions WG to provide this guidance. Also, one minor correction, my good friend William Kammerer, while an enormous fount of X12 knowledge, was never the chair of X12C. However, both William and I have been long time members of X12C - my participation starting in 1988. Hope this helps. Rachel Foerster -----Original Message----- From: Kepa Zubeldia [mailto:[EMAIL PROTECTED]] Sent: Saturday, October 27, 2001 9:20 PM To: [EMAIL PROTECTED]; [EMAIL PROTECTED]; HIPAAlive; X12N Subject: TCS: HL structure clarification There has been some debate on the proper structuring of HL loops for the HIPAA transactions. This is very important, as it could make the HIPAA transactions totally unprocessable by the receiver. The X12 standard is somewhat subject to interpretation as to what is a "top-down/left-right" ordered structure. So I asked William Kammerer, past X12C chair. His response is below. I think that X12N, SNIP, or DHHS ought to submit a "Request for interpretation" to X12C as soon as possible on this topic. In the meantime, maybe X12N, SNIP, or DHHS can address this topic. Comments? Kepa Zubeldia Claredi "William J. Kammerer" wrote: I looked at both X12.6 Application Control Structure and 12.59 Implementation of EDI Structures - Semantic Impact, and though the latter mentions the HL, there is no mention that subordinate HL loops must be contiguous to their parent in a top-down left-to-right manner. But there is a segment comment associated with the HL that says "The HL segment defines a top-down/left-right ordered structure," for whatever that's worth. I realize that doesn't definitively mean the HLs have to be physically in that order in the data. "Does in order mean that all the children HL must immediately follow their parent HL before there is another parent HL?" I would maintain that, yes, in-order means top-down, left to right ordering. "Is that stated somewhere in X12?" Not explicitly in X12.6, X12.59 nor in the HL dictionary itself, as I indicated above. I think this calls for a Request for Interpretation. If I had still been "chair" of X12C TG2, I would have been the one to write the response. Actually, even if X12 doesn't address the issue, shouldn't the HIPAA IGs explicitly lay down this rule once and for all? William J. Kammerer Novannet, LLC. +1 (614) 487-9286 +1 (614) 638-4384 (c) +1 (520) 396-6310 (FAX) ----- Original Message ----- From: "Kepa Zubeldia" <[EMAIL PROTECTED]> To: "William J. Kammerer" <[EMAIL PROTECTED]> Subject: Re: TCS: Hierarchical Level Structure William, What does "in order" mean? If someone sends all the "insured HL" in order first and then all the "patient HL" in order also, but from a patient HL is pointing to an insured HL that is many levels above as being the parent, is that out of order? Does in order mean that all the children HL must immediately follow their parent HL before there is another parent HL? Is that stated somewhere in X12? ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=business and enter your email address. ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request.
