stupidedi 1.3.23 → 1.4.0

data/spec/fixtures/X222-HC837/8-good.txt

@@ -1,52 +0,0 @@
-Example 8 - Wheelchair 
-
-The patient is the subscriber. Claim is submitted by the provider directly to a Medicare DMERC carrier.
-
-ISA*00*..........*01*SECRET....*ZZ*SUBMITTERS.ID..*ZZ*RECEIVERS.ID...*030101*1253*^*00501*000000905*1*T*:~
-GS*HC*SENDER CODE*RECEIVER CODE*19991231*0802*1*X*005010X222~
-ST*837*112233*005010X222~
-BHT*0019*00*16*20050326*1036*CH~
-NM1*41*2*XYZ WHEELCHAIRS INC*****46*ABC55~
-PER*IC*JANE*TE*2225551111~
-NM1*40*2*DMERC CARRIER*****46*99999~
-HL*1**20*1~
-NM1*85*2*XYZ WHEELCHAIR INC*****XX*1232343560~
-N3*1440 NORTH STREET~
-N4*LAFAYETTE*IN*479041440~
-REF*EI*123567989~
-HL*2*1*22*0~
-SBR*P*18*******MB~
-PAT*******01*155~
-NM1*IL*1*SMITH*JAMES****MI*987654321A~
-N3*12 MAIN ST~
-N4*FRANKFORT*IN*46209~
-DMG*D8*19201023*M~
-NM1*PR*2*DMERC CARRIER*****PI*99999~
-N4*INDIANAPOLIS*IN*46209~
-CLM*SMI123*75***12:B:1*Y*A*Y*Y~
-HI*BK:436*BF:3449~
-LX*1~
-SV1*HC:K0001:RR:KH:BR*75*UN*1***1:2~
-SV5*HC:K0001*DA*4*200*500*4~
-PWK*CT*AD~
-CR3*I*MO*99~
-CRC*09*Y*38~
-DTP*472*RD8*20050321-20050321~
-DTP*463*D8*20040321~
-DTP*461*D8*20050321~
-MEA*TR*HT*70~
-NM1*DK*1*WILSON*RANDALL****XX*1111155556~
-N3*1226 WEST RAILROAD STREET~
-N4*LAFAYETTE*IN*47905~
-PER*IC*LEE*TE*7659259999~
-LQ*UT*02.03B~
-FRM*1*Y~
-FRM*2*N~
-FRM*3*N~
-FRM*4*N~
-FRM*5**8~
-FRM*8*N~
-FRM*9*Y~
-SE*44*112233~
-GE*1*1~
-IEA*1*000000905~

data/spec/fixtures/X222-HC837/9-bad.txt

@@ -1,56 +0,0 @@
-Example 9 - Anesthesia 
-
-The patient is the subscriber. The payer is Medicare. The claim is billed directly to Medicare.
-
-Errors Found in File 5010X222-9
-* W10009:Padding, spaces or control characters detected after segment terminator.
-* H10203:Functional Group ID 'XX' mismatch - Transaction Set is type 'HC'
-* H11204:Code Value 'XX' not used for element 'GS01'
-* H24402:The value '2366554859' fails the check digit algorithm for the "HIPAA National Provider ID (NPI)"
-* H25377:The 'Billing Provider Postal Zone or ZIP Code' must be the nine digit Zip code.
-* H20205:Incomplete loop (2010BB). Missing HIPAA-required N4 (Payer City, State, ZIP Code).
-* H10602:Assuming Sub-Element Delimiter is > rather than : in CLM05
-* W22004:Your data contains character(s) from the extended character set which may only be used by agreement between communicating parties.
-* H10602:Assuming Sub-Element Delimiter is > rather than : in HI01
-* H20617:The value '5678912345' does not match the format for a "HIPAA National Provider ID (NPI)"
-* H20204:Code Value 'ZZ' at element 'PRV02' is valid in the X12 standard, but not in this HIPAA implementation
-* H46000:The 'Rendering Provider Secondary Identification' is not allowed because the National Provider Identifier has been mandated as the only valid provider identifier for HIPAA transactions
-* B20617:Currently the "HIPAA National Provider ID (NPI)" is only being issued with the first digit equal to 1 or 2, with 3 and 4 reserved for future assignment
-* H20617:The value '432198765' does not match the format for a "HIPAA National Provider ID (NPI)"
-* H25377:The 'Laboratory or Facility Postal Zone or ZIP Code' must be the nine digit Zip code.
-* H10602:Assuming Sub-Element Delimiter is > rather than : in SV101
-* B45272:Use of MJ in SV103 indicates Anesthesia Administration, which requires the presence of the Anesthesia Related Surgical Procedure (2300 HI01 = BP).
-
-ISA*00*..........*01*SECRET....*ZZ*SUBMITTERS.ID..*ZZ*RECEIVERS.ID...*030101*1253*^*00501*000000905*1*T*:~
-GS*XX*SENDER CODE*RECEIVER CODE*19991231*0802*1*X*005010X222~
-ST*837*0001*005010X222~
-BHT*0019*00*0123*20050117*1023*CH~
-NM1*41*2*PROVIDER MEDICAL GROUP*****46*N305~
-PER*IC*NINA*TE*6155551212*EX*911~
-NM1*40*2*ABC PAYER*****46*05440~
-HL*1**20*1~
-NM1*85*2*PROVIDER MEDICAL GROUP*****XX*2366554859~
-N3*1234 WEST END AVE~
-N4*NASHVILLE*TN*37232~
-REF*EI*756473826~
-HL*2*1*22*0~
-SBR*P*18*******MB~
-NM1*IL*1*JONES*MARGARET****MI*123456789A~
-N3*123 RAINBOW ROAD~
-N4*NASHVILLE*TN*37232~
-DMG*D8*19740303*F~
-NM1*PR*2*ABC PAYER*****PI*05440~
-CLM*153829140*827***22>B>1*Y*A*Y*Y~
-HI*BK>36616~
-NM1*82*1*TOWNSEND*JACOB*E***XX*5678912345~
-PRV*PE*ZZ*207L00000X~
-REF*1G*A41234~
-NM1*77*2*PROVIDER OP HOSP*****XX*432198765~
-N3*345 MAIN DRIVE~
-N4*NASHVILLE*TN*37232~
-LX*1~
-SV1*HC>00142>QK>QS>P1*827*MJ*61***1~
-DTP*472*D8*20050112~
-SE*29*0001~
-GE*1*1~
-IEA*1*000000905~

data/spec/fixtures/X222-HC837/9-good.txt

@@ -1,38 +0,0 @@
-Example 9 - Anesthesia 
-
-The patient is the subscriber. The payer is Medicare. The claim is billed directly to Medicare.
-
-ISA*00*..........*01*SECRET....*ZZ*SUBMITTERS.ID..*ZZ*RECEIVERS.ID...*030101*1253*^*00501*000000905*1*T*:~
-GS*HC*SENDER CODE*RECEIVER CODE*19991231*0802*1*X*005010X222~
-ST*837*0001*005010X222~
-BHT*0019*00*0123*20050117*1023*CH~
-NM1*41*2*PROVIDER MEDICAL GROUP*****46*N305~
-PER*IC*NINA*TE*6155551212*EX*911~
-NM1*40*2*ABC PAYER*****46*05440~
-HL*1**20*1~
-NM1*85*2*PROVIDER MEDICAL GROUP*****XX*2366554857~
-N3*1234 WEST END AVE~
-N4*NASHVILLE*TN*372321234~
-REF*EI*756473826~
-HL*2*1*22*0~
-SBR*P*18*******MB~
-NM1*IL*1*JONES*MARGARET****MI*123456789A~
-N3*123 RAINBOW ROAD~
-N4*NASHVILLE*TN*37232~
-DMG*D8*19740303*F~
-NM1*PR*2*ABC PAYER*****PI*05440~
-N4*NASHVILLE*TN*37232~
-CLM*153829140*827***22:B:1*Y*A*Y*Y~
-HI*BK:36616~
-HI*BP:94542~
-NM1*82*1*TOWNSEND*JACOB*E***XX*1232343560~
-PRV*PE*PXC*207L00000X~
-NM1*77*2*PROVIDER OP HOSP*****XX*1432198764~
-N3*345 MAIN DRIVE~
-N4*NASHVILLE*TN*372323450~
-LX*1~
-SV1*HC:00142:QK:QS:P1*827*MJ*61***1~
-DTP*472*D8*20050112~
-SE*30*0001~
-GE*1*1~
-IEA*1*000000905~

data/spec/fixtures/X223-HC837/1-bad.txt

@@ -1,66 +0,0 @@
-Business Scenario 1- 837 Institutional Claim 
-
-The patient is the subscriber. The primary payer is Medicare and the secondary payer is State Teachers. The claim has a Type of Bill of 0141.
-
-Errors Found in File 5010X223A1-1
-* W10009:Padding, spaces or control characters detected after segment terminator.
-* H10203:Functional Group ID 'XX' mismatch - Transaction Set is type 'HC'
-* H11204:Code Value 'XX' not used for element 'GS01'
-* H52000:Provider Specialty Code '203BA0200N' not found in Taxonomy Code Table.
-* H20617:The value '9876540809' does not match the format for a "HIPAA National Provider ID (NPI)"
-* H25377:The 'Billing Provider Postal Zone or ZIP Code' must be the nine digit Zip code.
-* H20203:Element CLM06 is present, though marked 'Not Used'
-* H20204:Code Value 'D8' at element 'DTP02' is valid in the X12 standard, but not in this HIPAA implementation
-* H51105:'A2' is not a valid NUBC Value Code.
-* H46000:The 'Attending Provider Secondary Identification' is not allowed because the National Provider Identifier has been mandated as the only valid provider identifier for HIPAA transactions
-* H46216:The Other Insurance Group Name must not be used if the Group Number is submitted.
-* H10023:Unexpected segment (DMG)
-* W24413:Submitters are encouraged to routinely send a Line Item Control Number on all service lines.
-
-ISA*00*..........*01*SECRET....*ZZ*SUBMITTERS.ID..*ZZ*RECEIVERS.ID...*030101*1253*^*00501*000000905*1*T*:~
-GS*XX*SENDER CODE*RECEIVER CODE*19991231*0802*1*X*005010X223A1~
-ST*837*987654*005010X223A1~
-BHT*0019*00*0123*19960918*0932*CH~
-NM1*41*2*JONES HOSPITAL*****46*12345~
-PER*IC*JANE DOE*TE*9005555555~
-NM1*40*2*MEDICARE*****46*00120~
-HL*1**20*1~
-PRV*BI*PXC*203BA0200N~
-NM1*85*2*JONES HOSPITAL*****XX*9876540809~
-N3*225 MAIN STREET BARKLEY BUILDING~
-N4*CENTERVILLE*PA*17111~
-REF*EI*567891234~
-HL*2*1*22*0~
-SBR*P*18*******MB~
-NM1*IL*1*DOE*JOHN*T***MI*030005074A~
-N3*125 CITY AVENUE~
-N4*CENTERVILLE*PA*17111~
-DMG*D8*19261111*M~
-NM1*PR*2*MEDICARE B*****PI*00435~
-REF*G2*330127~
-CLM*756048Q*89.93***14:A:1*Y*A*Y*Y~
-DTP*434*D8*19960911~
-CL1*3**01~
-HI*BK:3669~
-HI*BF:4019*BF:79431~
-HI*BH:A1:D8:19261111*BH:A2:D8:19911101*BH:B1:D8:19261111*BH:B2:D8:19870101~
-HI*BE:A2:::15.31~
-HI*BG:09~
-NM1*71*1*JONES*JOHN*J~
-REF*1G*B99937~
-SBR*S*01*351630*STATE TEACHERS*****CI~
-DMG*D8*19271211*F~
-OI***Y***Y~
-NM1*IL*1*DOE*JANE*S***MI*222004433~
-N3*125 CITY AVENUE~
-N4*CENTERVILLE*PA*17111~
-NM1*PR*2*STATE TEACHERS*****PI*1135~
-LX*1~
-SV2*0305*HC:85025*13.39*UN*1~
-DTP*472*D8*19960911~
-LX*2~
-SV2*0730*HC:93005*76.54*UN*3~
-DTP*472*D8*19960911~
-SE*43*987654~
-GE*1*1~
-IEA*1*000000905~

data/spec/fixtures/X223-HC837/1-good.txt

@@ -1,53 +0,0 @@
-Business Scenario 1- 837 Institutional Claim 
-
-The patient is the subscriber. The primary payer is Medicare and the secondary payer is State Teachers. The claim has a Type of Bill of 0141.
-
-ISA*00*..........*01*SECRET....*ZZ*SUBMITTERS.ID..*ZZ*RECEIVERS.ID...*030101*1253*^*00501*000000905*1*T*:~
-GS*HC*SENDER CODE*RECEIVER CODE*19991231*0802*1*X*005010X223A1~
-ST*837*987654*005010X223A1~
-BHT*0019*00*0123*19960918*0932*CH~
-NM1*41*2*JONES HOSPITAL*****46*12345~
-PER*IC*JANE DOE*TE*9005555555~
-NM1*40*2*MEDICARE*****46*00120~
-HL*1**20*1~
-PRV*BI*PXC*261QM1300X~
-NM1*85*2*JONES HOSPITAL*****XX*1232343560~
-N3*225 MAIN STREET BARKLEY BUILDING~
-N4*CENTERVILLE*PA*171112251~
-REF*EI*567891234~
-HL*2*1*22*0~
-SBR*P*18*******MB~
-NM1*IL*1*DOE*JOHN*T***MI*030005074A~
-N3*125 CITY AVENUE~
-N4*CENTERVILLE*PA*17111~
-DMG*D8*19261111*M~
-NM1*PR*2*MEDICARE B*****PI*00435~
-N4*CENTERVILL*PA*17111~
-REF*G2*330127~
-CLM*756048Q*89.93***14:A:1**A*Y*Y~
-DTP*434*RD8*19960911-19960911~
-CL1*3**01~
-HI*BK:3669~
-HI*BF:4019*BF:79431~
-HI*BH:A1:D8:19261111*BH:A2:D8:19911101*BH:B1:D8:19261111*BH:B2:D8:19870101~
-HI*BE:38:::15.31~
-HI*BG:09~
-NM1*71*1*JONES*JOHN*J***XX*1232343560~
-SBR*S*01*351630******CI~
-OI***Y***Y~
-NM1*IL*1*DOE*JANE*S***MI*222004433~
-N3*125 CITY AVENUE~
-N4*CENTERVILLE*PA*17111~
-NM1*PR*2*STATE TEACHERS*****PI*1135~
-N4*CENTERFIELD*PA*17111~
-LX*1~
-SV2*0305*HC:85025*13.39*UN*1~
-DTP*472*D8*19960911~
-REF*6R*123~
-LX*2~
-SV2*0730*HC:93005*76.54*UN*3~
-DTP*472*D8*19960911~
-REF*6R*124~
-SE*45*987654~
-GE*1*1~
-IEA*1*000000905~

data/spec/fixtures/X223-HC837/2-bad.txt

@@ -1,69 +0,0 @@
-Business Scenario 2- Two Claims for the Same Provider
-
-For both claims, the patient is the subscriber and the transaction is being directly submitted from the provider to the payer.This example contains two claims for the same provider.
-
-Errors Found in File 5010X223A1-2
-* W10009:Padding, spaces or control characters detected after segment terminator.
-* H10203:Functional Group ID 'XX' mismatch - Transaction Set is type 'HC'
-* H11204:Code Value 'XX' not used for element 'GS01'
-* H24402:The value '1234567890' fails the check digit algorithm for the "HIPAA National Provider ID (NPI)"
-* H25377:The 'Billing Provider Postal Zone or ZIP Code' must be the nine digit Zip code.
-* H20203:Element CLM06 is present, though marked 'Not Used'
-* H25405:The Admission Source Is required for all inpatient and outpatient services.
-* H46000:The 'Attending Provider Secondary Identification' is not allowed because the National Provider Identifier has been mandated as the only valid provider identifier for HIPAA transactions
-* W24413:Submitters are encouraged to routinely send a Line Item Control Number on all service lines.
-* H20617:The value '9999999999' does not match the format for a "HIPAA National Provider ID (NPI)"
-* H52003:Attending Provider Specialty Code '363LP0200N' not found in Taxonomy Code Table
-
-ISA*00*..........*01*SECRET....*ZZ*SUBMITTERS.ID..*ZZ*RECEIVERS.ID...*030101*1253*^*00501*000000905*1*T*:~
-GS*XX*SENDER CODE*RECEIVER CODE*19991231*0802*1*X*005010X223A1~
-ST*837*987654*005010X223A1~
-BHT*0019*00*0123*20050630*0932*CH~
-NM1*41*2*JONES HOSPITAL*****46*12345~
-PER*IC*JANE DOE*TE*1112223333~
-NM1*40*2*TRICARE*****46*99999~
-HL*1**20*1~
-PRV*BI*PXC*282N00000X~
-NM1*85*2*JONES HOSPITAL*****XX*1234567890~
-N3*225 MAIN STREET~
-N4*ANYWHERE*PA*17111~
-REF*EI*123456789~
-HL*2*1*22*0~
-SBR*P*18*******CH~
-NM1*IL*1*DOE*JOHN*T***MI*030005074~
-N3*125 CITY AVENUE~
-N4*ANYWHERE*PA*17111~
-DMG*D8*19681111*M~
-NM1*PR*2*TRICARE*****PI*99999~
-CLM*756048Q*89.95***13:A:1*Y*C*Y*Y~
-DTP*434*RD8*20050315-20050315~
-CL1***01~
-HI*BK:3669~
-HI*BF:4019*BF:79431~
-NM1*71*1*JONES*JOHN*J***XX*1122334455~
-REF*1G*U12345~
-LX*1~
-SV2*0305*HC:85025*13.39*UN*1~
-DTP*472*D8*20050315~
-LX*2~
-SV2*0730*HC:93010*76.56*UN*3~
-DTP*472*D8*20050315~
-HL*3*1*22*0~
-SBR*P*18*******CH~
-NM1*IL*1*SMITH*JOE****MI*123405074~
-N3*5 MAIN STREET~
-N4*ANYWHERE*PA*17111~
-DMG*D8*19621210*M~
-NM1*PR*2*TRICARE*****PI*99999~
-CLM*756049Q*50***13:A:1*Y*C*Y*Y~
-DTP*434*RD8*20050401-20050401~
-CL1***01~
-HI*BK:30000~
-NM1*71*1*JONES*JUDY*J***XX*9999999999~
-PRV*AT*PXC*363LP0200N~
-LX*1~
-SV2*0300*HC:85087*50*UN*1~
-DTP*472*D8*20050401~
-SE*48*987654~
-GE*1*1~
-IEA*1*000000905~

data/spec/fixtures/X223-HC837/2-good.txt

@@ -1,60 +0,0 @@
-Business Scenario 2- Two Claims for the Same Provider
-
-For both claims, the patient is the subscriber and the transaction is being directly submitted from the provider to the payer.This example contains two claims for the same provider.
-
-ISA*00*..........*01*SECRET....*ZZ*SUBMITTERS.ID..*ZZ*RECEIVERS.ID...*030101*1253*^*00501*000000905*1*T*:~
-GS*HC*SENDER CODE*RECEIVER CODE*19991231*0802*1*X*005010X223A1~
-ST*837*987654*005010X223A1~
-BHT*0019*00*0123*20050630*0932*CH~
-NM1*41*2*JONES HOSPITAL*****46*12345~
-PER*IC*JANE DOE*TE*1112223333~
-NM1*40*2*TRICARE*****46*99999~
-HL*1**20*1~
-PRV*BI*PXC*282N00000X~
-NM1*85*2*JONES HOSPITAL*****XX*1232343560~
-N3*225 MAIN STREET~
-N4*ANYWHERE*PA*171112251~
-REF*EI*123456789~
-HL*2*1*22*0~
-SBR*P*18*******CH~
-NM1*IL*1*DOE*JOHN*T***MI*030005074~
-N3*125 CITY AVENUE~
-N4*ANYWHERE*PA*17111~
-DMG*D8*19681111*M~
-NM1*PR*2*TRICARE*****PI*99999~
-N4*ANYWHERE*PA*17111~
-CLM*756048Q*89.95***13:A:1**C*Y*Y~
-DTP*434*RD8*20050315-20050315~
-CL1**7*01~
-HI*BK:3669~
-HI*BF:4019*BF:79431~
-NM1*71*1*JONES*JOHN*J***XX*1122334455~
-LX*1~
-SV2*0305*HC:85025*13.39*UN*1~
-DTP*472*D8*20050315~
-REF*6R*123~
-LX*2~
-SV2*0730*HC:93010*76.56*UN*3~
-DTP*472*D8*20050315~
-REF*6R*124~
-HL*3*1*22*0~
-SBR*P*18*******CH~
-NM1*IL*1*SMITH*JOE****MI*123405074~
-N3*5 MAIN STREET~
-N4*ANYWHERE*PA*17111~
-DMG*D8*19621210*M~
-NM1*PR*2*TRICARE*****PI*99999~
-N4*ANYWHERE*PA*17111~
-CLM*756049Q*50***13:A:1**C*Y*Y~
-DTP*434*RD8*20050401-20050401~
-CL1**7*01~
-HI*BK:30000~
-NM1*71*1*JONES*JUDY*J***XX*1232343560~
-PRV*AT*PXC*204C00000X~
-LX*1~
-SV2*0300*HC:85087*50*UN*1~
-DTP*472*D8*20050401~
-REF*6R*224~
-SE*52*987654~
-GE*1*1~
-IEA*1*000000905~

data/spec/fixtures/X223-HC837/3-bad.txt

@@ -1,89 +0,0 @@
-Business Scenario 3- PPO Repriced Claim
-
-The patient is not the subscriber. Repriced claim is being transmitted from a Regional Preferred Provider Organization to a commercial health insurance company. In this situation, the hospital has sent the claim to a clearinghouse, which then forwarded the claim to the repricer; the claim has been repriced and is now being forwarded to the appropriate payer for payment.
-
-Errors Found in File 837I 5010X223A1-3
-* W10009:Padding, spaces or control characters detected after segment terminator.
-* H10203:Functional Group ID 'XX' mismatch - Transaction Set is type 'HC'
-* H11204:Code Value 'XX' not used for element 'GS01'
-* H25423:The Implementation Convention Reference value must be '005010X223A1'.
-* H24402:The value '1257234346' fails the check digit algorithm for the "HIPAA National Provider ID (NPI)"
-* H20205:Incomplete loop (2010BB). Missing HIPAA-required N4 (Payer City, State, ZIP Code).
-* H10602:Assuming Sub-Element Delimiter is > rather than : in CLM05
-* W22004:Your data contains character(s) from the extended character set which may only be used by agreement between communicating parties.
-* H20203:Element CLM06 is present, though marked 'Not Used'
-* H24391:Missing HIPAA Required 'CLM07'.
-* H46465:Admission Date (DTP-01=435) was not expected because this claim is not for Inpatient Services.
-* W24411:The Claim Pricing/Repricing Information is to be completed by repricers only.
-* H10602:Assuming Sub-Element Delimiter is > rather than : in HI01
-* H10602:Assuming Sub-Element Delimiter is > rather than : in HI01
-* H20204:Code Value 'BF' at element 'HI0101' is valid in the X12 standard, but not in this HIPAA implementation
-* H61012:Treatment Code Information was not expected because the Claim Facility Type (CLM-05-1) is not between 30 and 39
-* H10602:Assuming Sub-Element Delimiter is > rather than : in HI01
-* H20203:Element HI0103 is present, though marked 'Not Used'
-* H20203:Element HI0104 is present, though marked 'Not Used'
-* H20204:Code Value 'BH' at element 'HI0101' is valid in the X12 standard, but not in this HIPAA implementation
-* H51113:'11' is not a valid Treatment Code.
-* W24411:The Claim Pricing/Repricing Information is to be completed by repricers only.
-* H20617:The value '5544332211' does not match the format for a "HIPAA National Provider ID (NPI)"
-* H10023:Unexpected segment (DMG)
-* H20205:Incomplete loop (2330A). Missing HIPAA-required N4 (Other Subscriber City, State, ZIP Code).
-* H20205:Incomplete loop (2330B). Missing HIPAA-required N4 (Other Payer City, State, ZIP Code).
-* W24413:Submitters are encouraged to routinely send a Line Item Control Number on all service lines.
-* H10602:Assuming Sub-Element Delimiter is > rather than : in SV202
-* W24413:Submitters are encouraged to routinely send a Line Item Control Number on all service lines.
-* H10602:Assuming Sub-Element Delimiter is > rather than : in SV202
-
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