In transaction 278 Request (authorization) we have HI and UM segments to send services or diagnosis for which authorization is requested. 
 
1)    HI - Healthcare diangnosis at subscriber HL
2)    HI - Healthcare diagnosis at dependent HL
3)    HI - Healthcare diagnosis at Service level
4)    UM - At service level it contains general code values given in HIPAA IG for 278. 
 
Unlike HI (uses CPT, HCPCS codes), UM consists of service type code (UM03).
 
As per Imp. Guide, use of HI segments is *Situational* and use of UM is *Required*.
 
Further within UM,  first two elements "UM01 and UM02" are mandatory. 
But element that contains general service codes "UM03" is optional.  
 
In my view, at least at one place service info should have been mandatory.
 
The situation leads to many Questions:
1) What does the request for authorization without service info. mean?
2) How will payer process the request transaction, if we do not send any related info in 278 request?
3) If non occurance of HI and UM03 is valid transaction,  what will the response from Payor?
4) What should I do to send the request which contains service info and is mandatory as per HIPAA requirement?
5) Should I make at least one of above specified segments mandatory so that user will have  to enter service info?
 
Any reply to this will be very helpful.
 
Thanks for patient reading and best regards
 
Deepan Vashi


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