PH62752: 277CA INDICATES ACCEPTANCE WITH ERROR AT PROVIDER LEVEL WITH VALID FILE INCLUDING CLAIM, BUT INVALID FILE DOES NOT

APAR status

• Closed as program error.

Error description

• An error is reported at the provider level of the claim.  The
  status in the 277CA indicates acceptance, and the valid file
  includes the claim, and the invalid file does not. So that part
  is consistent. What we need to investigate is why we are sorting
  that claim into the valid claims.
  

Local fix

• ITXCQ - ITX00062524
  ER / LV
  Circumvention: None
  

Problem summary

• Users Affected:
  IBM Transformation Extender Pack for Healthcare HIPAA
  
  Problem Description:
  Transactions that should have failed with rule 35122 are
  sometimes passing, and segment location provided causes entire
  transaction to fail, not just the claim in error
  
  Platforms Affected:
  ALL
  

Problem conclusion

• Corrected trees/data/hcsvu to correctly fail or rule 35122 - if
  any of the claims do not indicate a rendering provider, then the
  
  billing provider is the rendering provider, and billing provider
  
  HL Loop must include the PRV segment.
  
  Applies to:
  Healthcare Pack HIPAA 10.2.0, 10.2.1, 10.2.2.
  
  Fixed in the next service packs and releases.
  
  To obtain the fix for this APAR:
  
  To see if the next fix pack or product release is available,
  check the IBM Transformation Extender product Release Notes
  page: https://www.ibm.com/support/pages/node/318755
  
  If a fix pack release is available, download it from Fix
  Central:
  http://www.ibm.com/support/fixcentral/
  
  If a new product release is available, download it from
  PassportAdvantage:
  https://www.ibm.com/software/passportadvantage/pao_customer.html
  
  
  
  If the fix pack or product release is not available and you
  require the APAR fix immediately, request a Limited Availability
  
  
  
  Interim Fix (LAIF) by opening a support Case:
  https://www.ibm.com/mysupport
  

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