999 Acknowledgement: basic definition and example
The HIPAA 999 Implementation Acknowledgement 005010X231 transaction is a response that confirms a file was received and could be properly read by the translator. This transaction is intended to be used in version 5010. The 999 Acknowledgement can also report on exactly what syntax-related issue caused the errors on the original document. It can notify the sender whether the document was accepted or rejected. 999 Acknowledgement acknowledges receipt of the document, but it does not guarantee that the transaction will be put in use by the business process. For example, just because an acknowledgement is sent does not mean the claim will be processed into the adjudication system.
The 999 Acknowledgement will produce three type of results:
A – Accepted
R – Rejected
E – Accepted with errors
999 Acknowledgement Example
AK1: This segment refers to the (GS) group level of the original document. AK101 is equal to the GS01 of the original document. For example, if a document is a Claim, AK101= ‘HC’. If a document is an Eligibility Inquiry, AK101 = ‘HS’. AK102 = GS06 of the original document. This is the group control number. AK103 is the EDI implementation version sent in the GS08 of the original transaction.
AK2: This segment refers to the (ST) Transaction Set level of the document. AK201 is equal to the ST01 of the original document. For example, if a document is a Claim, AK201= 837. If a document is an Eligibility Inquiry then AK201 = 270. AK202 = ST02 of the original document. This is the transaction set control number. AK203 = is the EDI implementation version sent in the ST03 of the original transaction.
IK3: Used to report errors in a data segment and identify the location of the data segment. IK301 contains the segment name that has the error. The segment name in the second example is ‘CLM’. IK302 contains the numerical count position of this data segment from the start of the transaction set; in the example above the erroneous ‘CLM’ segment is in the 120th position. IK303 contains the loop ID where the error occurred. IK304 contains the error code and it specifies what the error is. In the second example, the code is ‘8’ which means “Segment Has Data Element Errors”.
IK4: Used to report errors in a data element and identify the location of the data element. IK401 contains the data element position in the segment that has an error. In the erroneous example, the error is in position 2; CLM-02. IK402 contains the data element reference number, CLM-02 = 782. IK403 contains the error code, it specifies what the error in the data element is, in the example the code is ‘I12’ which means “Implementation Pattern Match Failure” IK404 contains a copy of the bad data element data.
IK5: Used to report errors in a transaction set. IK501 indicates whether the whole document (ST SE) is ‘A’ Accepted, ‘R’ Rejected or ‘E’ Accepted with errors. Other codes such as ‘M’, ‘W’ or ‘X’ are available but are hardly ever being used, they are made for security decryption purposes. In erroneous example above, IK501 = ‘E’ that means the claim was accepted with errors. IK502 is not used in the example above. The purpose of IK502IK506 is to report an error code on the whole transaction. Some sample error codes include:
1-Transaction Set Not Supported
2-Transaction Set Trailer Missing
3-Transaction Set Control Number in Header and Trailer Do Not Match.