Thanks for making me laugh early on a Monday morning!  

I think however, that the External Code Source for the State Code (N402) is
22 which is identified as the National Zip Code and Post Office Directory.
This external code set also identifies the 'official' codes for the Canadian
Provinces.  

Therefore, only codes from the official guide and the list should be used in
a HIPAA compliant transaction.  

In fact the comment for N402 says that the data element is required only if
the City Name (N401) is in the U.S. or Canada.  There is the problem.....the
IG says that the data element N402 is required but the comment contradicts
that note.  I understand that 4050 will make N402 Situational (as it should
be based on the comment).   Until then we're STUCK!  

/Helene
 
Helene Guilfoy
Guilfoy Consulting, LLC
mobile: 717-468-8085
email: [EMAIL PROTECTED]

-----Original Message-----
From: William J. Kammerer [mailto:[EMAIL PROTECTED] 
Sent: Monday, March 31, 2003 9:11 AM
To: WEDI SNIP Transactions Workgroup List
Subject: Re: State Code Required -- What do you do with foreign countries

"What do you do with foreign countries?" You ignore, insult or bomb them
if you happen to be George "W" Bush. Hee, hee - a little anti-war humor
there.

Tami Leaver originally asked "if the address is in Dresden Germany how
would the state code be valued?" Chris Feahr said somewhere that I'm
"quite knowledgeable about these sorts of things." I'm not always
knowledgeable - but eternally curious. So to answer Tami's question, I
pulled myself away from important executive work in Berlin and hopped on
the next train to Dresden. After arriving and settling in, I immediately
set to doing my research. I accosted various natives in the train
station, the Altstadt and the Neustadt and inquired in my very best -
yet woefully ungrammatical - schoolboy German: "Welche Staat ist Dresden
in?" The answer was invariably "Sachsen." We call that "Saxony."

The state code for "Sachsen" can be found in the ISO 3166-2 Country
Subdivision Codes, available on the UN/LOCODE page at
http://www.unece.org/cefact/locode/service/main.htm. Thus, the state
code for Saxony is "SN" - the second part of the 3166-2 code "DE-SN" for
Sachsen. I never saw state codes used in addresses, though: the postal
code provides enough detail to differentiate any possible like named
burgs or cities. The only like-named cities an American must absolutely
be able to distinguish are Frankfurt on the Main vs. Frankfurt on the
Oder. The one on the Main River is the big one with the airport. All the
research to answer Tami's question, beer gedrinken and train gehopping
will explain my delay in giving the definitive answer to this pressing
question of using foreign state codes in HIPAA transactions.

Keep in mind not all the ISO 3166-2 Country Subdivision Codes fit in the
two alphanumeric bytes available in N402. Technically, the location
identifier in N405 and N406 should be used for non US state or Canadian
province codes, though these are marked unused in the HIPAA IGs. Since
state codes are often not used for postal addresses (e.g., as in
Germany), I would just stuff any old syntactically valid garbage in N402
to make the transaction "compliant." The city name and postal code are
sufficient for all non-US and non-Canadian addresses.

William J. Kammerer
Novannet, LLC.
Columbus, US-OH 43221-3859
+1 (614) 487-0320

----- Original Message -----
From: "Paul Weber" <[EMAIL PROTECTED]>
To: "WEDI SNIP Transactions Workgroup List"
<[EMAIL PROTECTED]>
Sent: Wednesday, 26 March, 2003 12:33 PM
Subject: Re: State Code Required -- What do you do with foreign
countries


I'm not sure I'd bet the farm on the USPS modifying their ZIP code
directory to reference other code sources.

As far as putting in a value of "FC" as a state identifier, this doesn't
mitigate the problem with those countries that have their own states or
similar administrative regions (i.e. Mexico, Argentina, Germany, Brazil,
etc.). The X12 standard for data element 156 clearly requires the code
as defined by the appropriate government agency.

Paul Weber


----- Original Message -----
From: "Doug Webb"
Date: Wed, 26 Mar 2003 08:31:55 -0600
To: "Paul Weber" , "WEDI SNIP Transactions Workgroup List"
Subject: Re: State Code Required -- What do you do with foreign
countries



Paul et al,
I remember that Medicare had an "official" list associated with the NSF
specs that included 'FC' for Foreign Country as a State Code.

 I'm not sure if USPS ever made this official, but if so, it could work.

If not, since this is an external list without the change timing
constraints of lists in the spec itself, could someone pressure USPS to
add it (or something similar) quickly?  USPS could also include the
various postal codes of the various other countries by reference in its
ZIP code list (with a value to use for those conutries that don't have
such a code).

The opinions expressed here are my own and not necessarily the opinion
of LCMH.

Douglas M. Webb
Computer System Engineer
Little Company of Mary Hospital & Health Care Centers
[EMAIL PROTECTED]

"This electronic message may contain information that is confidential
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  ----- Original Message -----
  From: Paul Weber
  To: WEDI SNIP Transactions Workgroup List
  Sent: Tuesday, March 25, 2003 04:11 PM
  Subject: RE: State Code Required -- What do you do with foreign
countries


  Relative to identifying Canada, please refer to the industry note on
N404 Country Code on page 69 of the implementation guide which reads:
"Required only if country is not USA". Therefore to identify Canada, you
would use the appropriate ISO-3166 value for that country.

  While the external code list for N402 (state/province code) does refer
to the USPS designators, the reference to the code source 22 in Appendix
C of the implementation guide specifically includes values for the
provinces and territories of Canada. However, and here's yet another
issue for consideration, these values do not include the code for
Nunavut as this territory did not exist when the 4010 standards were
published. Those in the know might also realize that the values in the
X12 standard for Canadian provincial/territorial abbreviations do not
fully match the values currently specified by the Canadian postal
service.

  One more thing about states/provinces coding...many countries (Mexico
immediately comes to mind) have postal geographic first level (state)
abbreviations that are longer than the two characters available in data
element 156.

  Also consider that N403 (Postal Code) is a required field in the guide
and that the external code source 51 linked to this element is the USPS
ZIP code directory. Hmmm...seems to me we can't put a foreign postal
code in here if we are also insisting that the only thing we can put in
N402 are the values in code source 22.

  As far as reporting the state code issue for foreign countries to X12,
I do not recall this ever being brought forward to the 834 workgroup nor
do I see a current (or historical) DSMO request for this issue to be
addressed as part of the 834 transaction. However I will bring it up at
the June trimester meeting of our 834 workgroup.

  Paul Weber
  916-449-6970
  [EMAIL PROTECTED]

  ----- Original Message -----
  From: "Helene Guilfoy" <[EMAIL PROTECTED]>
  Date: Tue, 25 Mar 2003 15:33:04 -0500
  To: "WEDI SNIP Transactions Workgroup List"
<[EMAIL PROTECTED]>
  Subject: RE: State Code Required -- What do you do with foreign
countries


Good question but one that does not seem to be answer-able! To make the
problem more evident - there are 16 states that have a Paris address.
God forbid that you should inadvertently select one of those states as
your 'required' state code. Then it could get really problematic! To
make matters even worse, the requirement for a state code requires the
use of the USPS State Codes so we can't even use a 'not otherwise
defined' code.

This was pointed out to X12 before the final addenda was published. I'm
told that we must wait until 4050 (and all of the NPRM, Final Rule
publishing) before this will be resolved. At that time the IG will be
changed to make the State Code situational based on the comment for N402
that says it is only required if the city name (N401) is in the US or
Canada. But then that makes the Country Code problematic since it is
only required when the address is outside of the US or Canada. So how do
we identify Canada? Hope there is not a Paris, Canada!

/Helene

Helene Guilfoy
Guilfoy Consulting, LLC
mobile: 717-468-8085
email: [EMAIL PROTECTED]

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Sent: Tuesday, March 25, 2003 2:52 PM
To: WEDI SNIP Transactions Workgroup List
Subject: RE: State Code Required -- What do you do with foreign
countries

OK,

Let me re-ask Peggy's question.

Is there an industry work around for and unvalued state code when the
address is foreign?

For example, if the address is in Dresden Germany  how would the state
code be valued?

Thanks!

Tami Leaver
Sr. Application Analyst
PA/PM Team
Medstar Health Information Systems
410-933-6905



                    "Bass, David (DHS-PSD)"

                    <[EMAIL PROTECTED]       To:     "WEDI SNIP
Translations Subworkgroup List"
                    t.mhg.edu>
<[EMAIL PROTECTED]>

                                                    cc:

                    03/24/03 01:43 PM               Subject:     RE:
State
Code Required -- What do you do with foreign countries
                    Please respond to "Bass,

                    David (DHS-PSD)"









That comment is taken from the standard. It was not created for the
implementation guide. In the standard, N402 is optional, hence the
comment.
The IG requires it regardless.

________________________________
"And the saga continues..."

David Bass
DHS, Office of HIPAA Compliance
Phone: (916) 255-5282
Fax: (916) 255-5271


-----Original Message-----
From: Paul Weber [mailto:[EMAIL PROTECTED]
Sent: Monday, March 24, 2003 9:49 AM
To: WEDI SNIP Translations Subworkgroup List
Subject: RE: State Code Required -- What do you do with foreign
countries



The N4 segment (Member Residence City, State, ZIP Code) in Loop 2100A of
the 834 has a specific comment on element N402 (State or Province Code)
that reads "N402 is required only if city name (N401) is in the U.S. or
Canada."

I'll leave it to others to debate whether the comment overrides the
USAGE REQUIRED statement of the implementation guide for this element.


Sincerely,
Paul Weber
916-449-6970
[EMAIL PROTECTED]


----- Original Message -----
From: "Peggy Honts" <[EMAIL PROTECTED]>
Date: Thu, 20 Mar 2003 19:14:10 -0500
To: "WEDI SNIP Translations Subworkgroup List"
<[EMAIL PROTECTED]>
Subject: RE: State Code Required -- What do you do with foreign
countries



Thank you Chris for forwarding my question. Even if they are not a
covered entity -- they believe and I agree when they use the transaction
it should be compliant. Also, if a covered entity receives a
non-compliant transaction -- they would not be able to use their
compliance checkers.


Peggy Honts, Vice President
HIPAA, Architecture & Data Services
AXIOM Systems, Inc.
20300 Century Blvd., Suite 120
Germantown, MD 20874
Direct 301-840-9165 X212
Cell 301-518-9930
e-Fax 928-752-1441
[EMAIL PROTECTED]


-----Original Message-----
From: Christopher Feahr [mailto:[EMAIL PROTECTED]
Sent: Thursday, March 20, 2003 6:56 PM
To: Peggy Honts; WEDI SNIP Translations Subworkgroup List
Cc: William J. Kammerer
Subject: Re: State Code Required -- What do you do with foreign
countries



Hello Peggy, I see very little traffic on this listserve (in fact, I
forgot I was even subscribed to it!).

I'm copying William Kammerer because he is quite knowledgeable about
these sorts of things. You may also wish to post your question to the
"transactions" listserve. Since the entity sending you the 834 will
likely not be a covered entity, you could leave it empty for subscribers
located outside the USA. (I'd be inclined to use whatever worked in a
case like this!)

Regards,
-Chris

Christopher J. Feahr
Optiserv Consulting (Vision Industry)
Office (707) 579-4984
Cell (707) 529-2268
http://Optiserv.com
http://VisionDataStandard.org

----- Original Message -----
From: "Peggy Honts" <[EMAIL PROTECTED]
To: "WEDI SNIP Translations Subworkgroup List"
<[EMAIL PROTECTED]
Sent: Thursday, March 20, 2003 2:48 PM
Subject: State Code Required -- What do you do with foreign countries



What do you do when building transactions (834) for subscribers that are
located in a foreign country. The implementation guide and the
compliance checkers all require a State Code. There is no State code.
Has anyone found a solution or work around for this requirement.

Peggy Honts, Vice President
HIPAA, Architecture & Data Services
AXIOM Systems, Inc.
20300 Century Blvd., Suite 120
Germantown, MD 20874
Direct 301-840-9165 X212
Cell 301-518-9930
e-Fax 928-752-1441
[EMAIL PROTECTED]



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