HIPAA Acknowledgment Report Viewer

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Payer Edits

Payer-specific edits

The HIPAA Acknowledgment Report Viewer displays all edits with error explanations. Even if a payer is not in the list below, error and edit information is displayed.

For supported payers, specific edit information is provided to further assist you in correcting your errors.

Please contact us if you would like to have your payer's edits included in the software.

› Click to see an example

For 277 error code STC*A7:511:85**U*2267.5******A7:503:85

Example Payer Specific Edit Information:

Example General Edit Information:


Error:

Edit Information: STC*A7:511:85**U*2267.5******A7:503:85
Possible Explanations
Billing Provider Address Line must be populated with accepted alpha numeric characters.
Edit Reference: X222.091.2010AA.N301.060

Billing Provider Address Line 2 must be populated with accepted alpha numeric characters.
Edit Reference: X222.091.2010AA.N302.040

Error:
Edit Information: STC*A7:511:85**U*2267.5******A7:503:85
Explanation
Billing Provider, Invalid character. Note: At least one other status code is required to identify the data element in error.


The software currently supports specific edits for the following payers:

Payer CodeNameNotesEdit Set
00011Cahaba Health Benefit Administration (RHHI)IAMedicare Part A
00020Pinnacle BSIARMedicare Part A
00130National Government Services (NGS)INMedicare Part A
00131National Government Services (NGS)ILMedicare Part A
00160National Government Services (NGS)KYMedicare Part A
00230TrispanLAMedicare Part A
00320Noridian Mutual Insurance Co.MNMedicare Part A
00322Noridian Mutual Insurance Co.AK and WAMedicare Part A
00325Noridian Mutual Insurance Co.ID and ORMedicare Part A
00326Noridian Mutual Insurance Co.Roll-up for AK, WA, ID, ORMedicare Part A
00332National Government Services (NGS)OHMedicare Part A
00380Palmetto GBASCMedicare Part A
00382Palmetto GBANCMedicare Part A
00450National Government Services (NGS)WIMedicare Part A
00452National Government Services (NGS)MIMedicare Part A
00453Wisconsin Physicians Services (WPS)VA and WVMedicare Part A
00512Cahaba GBAMSMedicare Part B
00520Pinnacle BSIARMedicare Part B
00522Pinnacle BSIOKMedicare Part B
00528Pinnacle BSILAMedicare Part B
00630National Government Services (NGS)IN and KYMedicare Part B
00836Noridian Mutual Insurance Co.AK, WA, and ORMedicare Part B
00880Palmetto GBASCMedicare Part B
00882Palmetto RRBAll states for RailroadMedicare Part B
00883Palmetto GBAOH and WVMedicare Part B
00904TrailBlazer Health EnterprisesVAMedicare Part B
00951Wisconsin Physicians Services (WPS)WIMedicare Part B
00952Wisconsin Physicians Services (WPS)ILMedicare Part B
00953Wisconsin Physicians Services (WPS)MIMedicare Part B
00954Wisconsin Physicians Services (WPS)MNMedicare Part B
01001Palmetto GBARoll-up number for CA, HI and NVMedicare Part A
01101Palmetto GBACAMedicare Part A
01102Palmetto GBACA - northernMedicare Part B
01192Palmetto GBACA - southernMedicare Part B
01201Palmetto GBAHI (includes American Samoa, Guam, and N. Mariana Islands)Medicare Part A
01202Palmetto GBAHI (includes American Samoa, Guam, and N. Mariana Islands)Medicare Part B
01301Palmetto GBANVMedicare Part A
01302Palmetto GBANVMedicare Part B
02001Palmetto GBARoll-up number for CA, HI, and NVMedicare Part B
03001Noridian Administrative ServicesRoll-up number for AZ, MT, ND, SD, UT, and WYMedicare Part A
03002Noridian Administrative ServicesRoll-up number for AZ, MT, ND, SD, UT and WYMedicare Part B
03101Noridian Administrative ServicesAZMedicare Part A
03102Noridian Administrative ServicesAZ,MT and UTMedicare Part B
03201Noridian Administrative ServicesMTMedicare Part A
03202Noridian Administrative ServicesMTMedicare Part B
03301Noridian Administrative ServicesNDMedicare Part A
03302Noridian Administrative ServicesND, SD, and WYMedicare Part B
03401Noridian Administrative ServicesSDMedicare Part A
03501Noridian Administrative ServicesUTMedicare Part A
03502Noridian Administrative ServicesUTMedicare Part B
03601Noridian Administrative ServicesWYMedicare Part A
04001TrailBlazer Health EnterprisesRoll-up number for CO, NM, OK, and TXMedicare Part A
04101TrailBlazer Health EnterprisesCOMedicare Part A
04102TrailBlazer Health EnterprisesCOMedicare Part B
04201TrailBlazer Health EnterprisesNMMedicare Part A
04202TrailBlazer Health EnterprisesNMMedicare Part B
04301TrailBlazer Health EnterprisesOKMedicare Part A
04302TrailBlazer Health EnterprisesOKMedicare Part B
04401TrailBlazer Health EnterprisesTXMedicare Part A
04402TrailBlazer Health EnterprisesTXMedicare Part B
05001Wisconsin Physician Services (WPS)Roll-up number for IA, KS, MO, and NEMedicare Part A
05002Wisconsin Physicians Services (WPS)Roll-up number for IA, KS, MO, and NEMedicare Part B
05101Wisconsin Physician Services (WPS)IAMedicare Part A
05130Connecticut General Life (CIGNA)IDMedicare Part B
05201Wisconsin Physician Services (WPS)KSMedicare Part A
05202Wisconsin Physicians Services (WPS)KS, IA, MO-easternMedicare Part B
05301Wisconsin Physician Services (WPS)MOMedicare Part A
05302Wisconsin Physicians Services (WPS)MO - westernMedicare Part B
05401Wisconsin Physician Services (WPS)NEMedicare Part A
05402Wisconsin Physicians Services (WPS)NEMedicare Part B
05535Connecticut General Life (CIGNA)NCMedicare Part B
09001First Coast Service OptionsRoll-up number for FL, PR, and VIMedicare Part A
09002First Coast Service OptionsRoll-up number for FL, PR, and VIMedicare Part B
09101First Coast Service OptionsFLMedicare Part A
09102First Coast Service OptionsFLMedicare Part B
09201First Coast Service OptionsPuerto Rico and Virgin IslandsMedicare Part A
09202First Coast Service OptionsPuerto Rico and Virgin IslandsMedicare Part B
10101Cahaba GBAALMedicare Part A
10102Cahaba GBAALMedicare Part B
10201Cahaba GBAGAMedicare Part A
10202Cahaba GBAGAMedicare Part B
10301Cahaba GBATNMedicare Part A
10302Cahaba GBATNMedicare Part B
12001Highmark Medicare ServicesRoll-up # for DC,MD,PA,NJMedicare Part A
12002Highmark Medicare ServicesRoll-up number for DE, DC, MD, NJ, and PAMedicare Part B
12101Highmark Medicare ServicesDEMedicare Part A
12102Highmark Medicare ServicesDEMedicare Part B
12201Highmark Medicare ServicesDCMedicare Part A
12202Highmark Medicare ServicesDCMedicare Part B
12301Highmark Medicare ServicesMDMedicare Part A
12302Highmark Medicare ServicesMDMedicare Part B
12401Highmark Medicare ServicesNJMedicare Part A
12402Highmark Medicare ServicesNJMedicare Part B
12501Highmark Medicare ServicesPAMedicare Part A
12502Highmark Medicare ServicesPAMedicare Part B
13001National Government Services (NGS)Roll-up number for CT and NYMedicare Part A
13002National Government Services (NGS)Roll-up number for CT and NYMedicare Part B
13101National Government Services (NGS)CTMedicare Part A
13102National Government Services (NGS)CTMedicare Part B
13201National Government Services (NGS)NYMedicare Part A
13202National Government Services (NGS)NY (formerly Empire-NGS)Medicare Part B
13282National Government Services (NGS)NY (formerly Health Now)Medicare Part B
13292National Government Services (NGS)NY (formerly GHI)Medicare Part B
14001National HeritageMEMedicare Part A
14002National HeritageMA, ME, NH, and VTMedicare Part B
14003National HeritageNH,VTMedicare Part A
14201National HeritageMAMedicare Part A
14401National HeritageRIMedicare Part A
14402National HeritageRIMedicare Part B
16003National HeritageRegion AMedicare DMERC
17003National Government Services (NGS)Region BMedicare DMERC
18003Connecticut General Life (CIGNA)Region CMedicare DMERC
19003Noridian Administrative ServicesRegion DMedicare DMERC
52280Mutual of Omaha/WPS48/50 statesMedicare Part A

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