Change Request Detail
No.
1176
Date
9/12/2012
Submitter
Type of Request
Professional Claim (HCFA 1500)
Status
DSMO Process Completed
Business Reason
ASC X12 TR3 005010X222 for submitting professional claims or encounter reports (837p) permits the inclusion of Condition Information in multiple HI segments with HInn composite -01 containing a value of "BG".  When such segments are present, HInn composite -02 may contain a value that identifies any NUBC code list.  Unfortunately, HInn composite values -03, -04, -05, -06, -07, -08, and -09 are all listed as Not Used, thus prohibiting inclusion of any data values from any NUBC code list.
Suggestion
Add language to the description of HInn composite -02 that requires use of HInn composites that are suitable to the type of NUBC code list data values being included in a transaction, and make HInn composites -03, -04, -05, -06, -07, -08, and -09 Situational rather than Not Used. 
DSMO Category
D
Recommendation
Disapprove.  This segment is correct as is; no additional value is needed with a Condition Code.
Appeal Recommendation