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Issue processing 5010 837 data

Sep 5, 2012 at 6:01 PM

Respected Sir,

I get the following error when trying to parse an EDI 837 (5010 format). I am using the latest API.

Segment 'NM1**1*JEWELL*ARAGON*H***XX*' in position 936 within transaction '201240' cannot be identified within the supplied specification for transaction set 837.

I don't have any trouble processing other 5010 data from the same batch, just that few files are failing because of the aforementioned issues.

Do one or more segments not adhere to the 837 5010 spec in the failed files?

Thank you for your help,
Nitin 

Coordinator
Sep 5, 2012 at 6:10 PM

The segment you are showing me is missing an Entity Type Identifier after the NM1*.

Usually this is two characters (i.e. IL means subscriber, QC means patient).  For most specifications this is not a problem, but since the 837 identifies multiple loops that start with NM1, it uses the Entity Type Identifier to resolve the Name loop that it is attempting to parse.

Have other systems you work with been able to parse this X12?

Do you know which Loop this should be representing?

I could modify the spec so that this won't cause an error, but it would basically be an unidentifed loop.

Sep 6, 2012 at 12:56 AM

Dear Sir,

Sorry for the delay in my response. It took me a little time to test it on a different system. Not surprising, it fails there as well. It appears to be in the Service loop (2400) and only occurs for some entries in a given claim. Other segments have the 1L identifier.

Here's a broader snippet of that particular segment:
LX*1~SV1*HC:00740:QZ*1120.00*UN*16***1~DTP*472*RD8*20120607-20120607~HL*74**20*1~NM1*85*1*LI*TEST123*****~N3*123 ST SUITE A~N4*MyCity*ST*12222247~HL*75*74*22*0~SBR*P*18*******MC~NM1*IL*1*FIRST*LAST*H***MI*0000111124~N3*123 ABC ST #11~N4*MyCity*ST*12345~DMG*D8*19000101*F~NM1*PR*2*ABCD*****PI*99999~N3*123 HEALTH*123 ST~N4*City*ST*895222242~CLM*018422221*12.00***41:B:1*Y*A*Y*Y~CR1*****DH*~CRC*07**~HI*BK:95919*BF:8471*BF:8472*BF:E9179*BF:E8499~NM1**1*First*LAST*
H***XX*~NM1*82*1*LI*NAME****XX*1692222229~LX*1~SV1*HC:A0425:SH*30.00*UN****1~ 

Your advice on how I can best handle this would be greatly appreciated.

Many thanks.

Coordinator
Sep 6, 2012 at 1:43 PM

See changeset 19670.  I have added an "UNIDENTIFIED" loop under the Claim "2300" loop so that it can parse this segment.  There is a test added to verify it will fix this in the Claim loop.  Let me know if there are other occurrences that are unaccounted for.

If your data source was intending to send you something in this loop they will need to fix it on their end so you know what that data was intended for.

Sep 7, 2012 at 1:36 AM

Dear Sir,

THANK YOU SO MUCH!!! This is simply awesome. I still haven't had a chance to test the change but I am going to shortly.

Honestly, I don't have words to thank you for your timely help, and that too on more than one occasion. My best wishes to you and your team for continued success.

Thanks again.
Sincerely,
Nitin