PM43145: HIPAA COMPLIANCE CHECK NOT REJECTING SECONDARY ID IN 2010BB/REF WHEN 2010AA/NM109 CONTAINS NPI IN 837 TRANSACTION FOR 5010X222A1

APAR status

• Closed as program error.

Error description

• The Compliance check map is not rejecting the REF segments on
  Loop 2010BB Billing Provider Secondary Identification (Qualifier
  G2 and LU) when 2010AA/NM109 contains NPI.
  
  For 2010BB REF - BILLING PROVIDER SECONDARY IDENTIFICATION
  segment, the Implementation Guide States: "Required on or after
  the mandated NPI Implementation Date when NM109 in Loop 2010AA
  is not used and an identification number other than the NPI is
  necessary for the receiver to identify the provider. If not
  required by this implementation guide, do not send."
  

Local fix

• WTXCQ - WTX00037951
  AR / AR
  Circumvention: None
  

Problem summary

• Users affected;
  WebSphere Transformation Extender Pack for HIPAA
  
  Problem Description:
  HIPAA Compliance Check not rejecting Secondary ID in 2010BB/REF
  when 2010AA/NM109 Contains NPI in an 837 transaction for
  5010X222A1
  
  platforms affected:
  ALL
  

Problem conclusion

• Compliance Check can enforce the the absent REFs when
  2010AA/NM109 is present.  This affects all 837 transaction.  New
  T4 Rules will be added to the master application.
  
  Delivered in:
  HCIP 4.3.2.1
  

Temporary fix

Comments

APAR Information

• APAR is sysrouted FROM one or more of the following:

• APAR is sysrouted TO one or more of the following:

Fix information

• Fixed component name

  WEBSPHERE HIPAA

• Fixed component ID

  5724M6100

Applicable component levels

• R431 PSY

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