PI65905: COMPLIANCE CHECK PROCESS DOES NOT DETECT AN ERROR WHEN THE 837 2430 LOOP SVD01 VALUE DOES NOT MATCH 2330B LOOP NM109 VALUE

APAR status

• Closed as program error.

Error description

• The Compliance Check process (map) does not detect an error
  when the 837 2430 Loop SVD01 value does not match 2330B Loop
  NM109 value.
  
  837P Implementation Guide: 2430:SVD01 "This identifier
  indicates the payer responsible for the reimbursement described
  in this iteration of the 2430 loop. The identifier indicates
  the Other Payer by matching the appropriate Other Payer Primary
  Identifier (Loop ID-2330B, element NM109)."
  
  The Compliance Check is indicating that the claim is valid when
  the 2430:SVD01 does not match any of the 2330B:NM109.
  
  The same error is not detected for the 837P:005010X222A1,
  837I:005010X223A2, 837D:005010X224A2 transactions.
  

Local fix

• TXRTC - 45962
  GM / JX
  Circumvention: None
  

Problem summary

• Users affected:
  IBM Transformation Extender Pack for HIPAA EDI and SPE
  Healthcare Payer Pack
  
  Problem Description:
  
  Compliance Check - 837 - 2430 SVD01 does not match 2330B-NM109
  
  Platforms affected:
  ALL
  

Problem conclusion

• Problem Conclusion:
  new rules have been added to handle this requirement.  A
  component rule was added to the LX loop of each of the Claims
  transactions (837P, 837D, 837I) to ensure that when the 2430 SVD
  is present, then we must also find a corresponding 2330B loop
  where the 2330B NM109 = 2430 SVD01.  New rules to qualifier file
  are 58653, 58654 & 58655. Exit libraries have also been
  modified.
  
  Applies to:
  HCIP IP HIPAA 4.4.1.6, 4.4.1.7
  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

  TX HIPPA EDI

• Fixed component ID

  5724M6100

Applicable component levels

• R441 PSY

     UP