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Back   Additional Information To Support a Health Care Claim or Encounter (004020X107)

Purpose

The Additional Information to Support a Health Care Claim or Encounter Implementation Guide describes the use of the ASC X12 Patient Information (275) transaction set for the following business usage:
  • Provide additional information, such as operative notes or ambulance mileage, to a health care payer, and/or local, state, or federal government agency regarding a health care patient claim or encounter.

Primary Trading Partners

Health care providers, clearinghouses, payers, and local, state, and federal government agencies.

Exceptions/Limitations

Provider to provider requests and responses for additional information. For that business usage of the 275, refer to Patient Information Request and Response Implementation Guide (Guide ID #55) which is currently under development.

References

This is the first implementation guide for this business purpose.

Coordination

ASC X12 Health Care Claim/Encounter (TG2/WG2); Health Care Claim Request for Additional Information (TG2/WG5); and HL7.

Additional Information

Registered 2/6/1998
Transaction Set ID 275 Standard Version 004020
ASC X12 DM# Owning Group X12N/TG2/WG2