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add 270 support for U gender #261

Merged
merged 1 commit into from
Sep 14, 2023
Merged

add 270 support for U gender #261

merged 1 commit into from
Sep 14, 2023

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JakeDMSnap
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@jrohrbaugh jrohrbaugh left a comment

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+1 for this change! We just released some code to add U to our 837 request, and it broke our 270 requests. If this is indeed valid, I'd love to see it merged ASAP

@jrohrbaugh
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@kputnam could you please take a look at this PR? Much appreciated!

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kputnam commented Sep 14, 2023

Since I no longer have the X12 spec, I can't check if this conforms to the spec.

I found stedi's documentation includes X279A1, which defines the 270 and 271 transaction sets, but it doesn't show element-level detail. I'm including this link because they have good reference documentation in general and it might be useful to others.

One of CMS's (Medicare) implementation guides does say U can be used for unknown. It would be unusual for Medicare to allow values which aren't allowed by the standard. Medicare is also often regarded as an authority in terms of what X12 should be accepted by commercial payers, so I'm going to say this is good enough evidence to suggest it's probably allowed by the standard.

If anyone does have the X279A1 guide, please let me know if U is not allowed in the implementation section and I will back this change out -- in that case users would need to create payer-specific transaction set grammars by copying the standard and making modifications.

I'll merge this and push a new version tonight. cc: @jrohrbaugh

@kputnam kputnam merged commit 78972b1 into kputnam:master Sep 14, 2023
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@jrohrbaugh
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confirmed that change fixed our problem. Thanks for the quick and detailed response! When I was researching I also found that CMS guide you shared, but I wasn't sure how official it was. I'll see if anyone at my company has access to an official spec.

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3 participants