Hal,
I agree with your reading of the IG regarding usage of the STC, but, unfortunately, am not able to control how the IG has been interpreted by third parties. Both our EDI translator and the third party web application we will use for certification have built the rules using a strict reading of the "REQUIRED" in the guide, without consideration of the notes. I expect this is the sort of issue that will be worked out during testing with an outside entity. -----Original Message----- From: Hal Scoggins [mailto:[EMAIL PROTECTED]] Sent: Wednesday, June 26, 2002 2:41 PM To: [EMAIL PROTECTED] Subject: RE: 277 STC at Subscriber level Michael, Regarding the TRN and DMG segments, we coded to the addendum, assuming it will be effective by the deadline date. The way I read the IG, the STC is not required at the Subscriber level if the Subscriber is not the Patient. I'm looking at note #1 on IG page 154. Granted that, technically, the Usage should have been changed to SITUATIONAL, as the TRN was. But the note lets us off the hook, IMO. In short, we're treating the STC at the Subscriber level as SITUATIONAL. BTW, my copy of the addendum adds a note to the DMG segment (addendum page 19, replacing original IG page 148), as well as changing the Usage, letting us off the hook there. Is your copy different? Hal Scoggins SBPA Systems, Inc. (281) 679-7272 x116 -----Original Message----- From: Lachenmayer, Michael [mailto:[EMAIL PROTECTED]] Sent: Wednesday, June 26, 2002 11:40 AM To: '[EMAIL PROTECTED]' Subject: 277 STC at Subscriber level The 4010 guide for the 276/277 has various segments on the 277 required at the subscriber level, even if the claim is not for the subscriber. Examples are the DMG, TRN, and STC. This is in conflict with note at the end of section 2.2.3.1.1 (pg 27), which says that claim related information should 'float', being placed at the level of the patient to whom the claim applies. While 4010a fixes this problem for the DMG and TRN (though the DMG change is not identified!), it does not change the STC requirement. How are you handling this requirement, especially in the instance where you have more than one dependent for the same subscriber, each with a claim with its own status? Or one dependent with multiple claims, each with its own status. Are there generic status and category codes which can be used at the subscriber level? Thanks for you help. Michael Lachenmayer Independence Blue Cross Ph: (215) 241-9453 Fx: (215) 241-4134 CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you have received this communication in error, please do not distribute and delete the original message. Please notify the sender by E-Mail at the address shown. 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