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Specifically, 835 and 837, and even more specifically, lists of the various status codes and their meanings.

I've found a couple of commercial sources via google and duckduckgo. Are any sources freely available?

Thanks.

Len Jaffe
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2 Answers2

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The specifications are copyrighted by DISA or WPC (in the case of the HIPAA standards -- which are essentially an augmented version of the base X12 standards) and available for purchase from them.

As Axel suggested however for the more popular transactions sets you can usually obtain implementation guides from the net, and these will generally have all what you need.

There are generally not machine readable versions of these specifications freely available, as the official versions cost a great deal.

Francis Upton IV
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  • Thanks for your answer. We're probably going to buy the 835 and 837 from WPC, but I've got access to parsers in all of languages in which I'm profcient (and a couple in which I'm not :-) ). So I'm just looking for the code definitions/explanations to I can apply meaning to the data while I mine it for info. – Len Jaffe Feb 18 '13 at 07:04
  • Any IG (Implementation Guide) will be good enough for that purpose; the content is substantially identical to what's in the standard. – Francis Upton IV Feb 18 '13 at 15:09
  • I've seen several IGs (at least I think that's what they were) and each wanted a different set of codes in the same field. I'm going to have to get some form of guide from my data source, that much is clear, but I'm looking for the docs that say "32 in field X means we need more info" and "1 in field Y means we're denying the claim" – Len Jaffe Feb 18 '13 at 18:47
  • Or am I misunderstanding what is contained in an IG? – Len Jaffe Feb 18 '13 at 18:47
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    Usually the IG would have this information; there is no other source for the information. The IG is normally a subset of the actual standard (with all of the descriptions). The IG can also contain additional clarifications/restrictions specific to that implementation. Maybe if you can provide a link to a specific IG you have a question about I can better respond. – Francis Upton IV Feb 18 '13 at 23:53
  • @FrancisUpton is it really the case that you can get far without the actual standards? Most implementation guides ive seen dont say much. WPC is run like a mafia and the standards are outlandishly expensive (15k per person per year) because they are a monopoly. I can't believe industries just accept this. especially healthcare – Azeli Sep 27 '18 at 08:32
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One option is to ask Google for the specific message types like Health Care Claim Payment/Advice (X12 835). This will show you loads of guides and documents.

Another option is to download a trial version of an EDI X15 mapping/converting tool and study its grammar files.

The Health Care Codes are here.

Axel Kemper
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  • Thank you for the pointers to the codes. That may be exactly what I'm looking for. I'll let you know when I've had some time to read them. – Len Jaffe Feb 18 '13 at 07:02