PH51308: 837D PASSES COMPLIANCE WHEN 2300 DTP SERVICE DATE NOT PRESENT BUT REQUIRED IF TRANSACTION NOT FOR PREDETERMINATION OF BENEFITS

APAR status

• Closed as program error.

Error description

• HIPAA 837D transaction passes compliance when 2300 DTP Service
  Date is not present though this is required if the transaction
  is not for Predetermination of Benefits.  The transaction is
  Predetermination of Benefits if CLM19 is included in the
  transaction. Any transaction that does not include CLM19 should
  be rejected if the 2300 DPT Service Date is missing.
  

Local fix

• ITXCQ - ITX00061689
  LV / LV
  Circumvention: None 
  

Problem summary

• Users Affected:
  IBM Transformation Extender Pack for Healthcare HIPAA
  
  Problem Description:
  837D is passing compliance when 2300 DTP Service Date is not
  present even though this is required if the transaction is not
  for Predetermination of Benefits.
  
  Platforms Affected:
  ALL
  

Problem conclusion

• New Rules 60363, 60364, and 60365 added to ensure  2300 DTP*472
  is present if CLM19 does not indicate pre-determination of
  benefits, and that 2300 DTP*472 or 2400 DTP*472 is NOT present
  if CLM 19 is PB
  
  Applies to:
  Healthcare Pack 10.0.0, 10.0.3, 10.1.0, 10.2.0, 10.2.1
  
  Fixed in the next service packs and releases.
  
  To obtain the fix for this APAR:
  
  To see if the next service pack or product release is available,
  check the IBM Transformation Extender Downloads page:
  http://www.ibm.com/support/entry/portal/product/other_software/t
  ransformation_extender
  
  If the service pack or product release is available, download it
  from Fix Central:
  http://www.ibm.com/support/fixcentral/
  
  If the service pack or product release is not available and you
  require the APAR fix immediately, request a Limited Availability
  Interim Fix (LAIF) by opening a PMR:
  http://www.ibm.com/support/servicerequest/Home.action
  
  Prior to version 9.0.0, IBM Transformation Extender was called
  IBM WebSphere Transformation Extender.
  

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

  ITX

• Fixed component ID

  5724Q2300

Applicable component levels