C.7 GS01 Functional Identifier Code HN Health Care ‘HN’ – Information Status Notification C.7 GS02 Application Sender Code PHC100680301406 Same value as ISA06. C.7 GS03 Application Receiver Code Same value as ISA08. C.8 GS04 Date Functional Group Creation Date in CCYYMMDD format C.8 GS05 Time Functional Group Creation Time in HHMM format C.8 GS06 Group Control Number Unique number within interchange. Will begin with 0001, and will be identical to GE02. C.8 GS07 Responsible Agency Code X - Accredited Standards ‘X’ Committee X12 C.8 GS08 Version/Release/Industry 005010X212 Version and transaction Identifier Code number C.9 GE Functional Group Trailer Total number of transaction Number of Transaction Sets C.9 GE01 1 sets included in the Include functional group. Unique number assigned C.9 GE02 Group Control Number by the sender that must be identical to GS06. ST-SE Each real-time request should contain a single 276 Claim Status Request wrapped in a single STSE. TR3 Reference Name Codes Expected Value Page # 36 ST Transaction Set Header 36 ST01 Transaction Set Identifier 276 276 Code 36 ST02 Transaction Set Control The Transaction Set Control Numbers in ST02 and SE02 Number must be identical. The number is assigned by the originator and must be unique within a functional group (GS-GE). 36 ST03 Implementation Convention 005010X212 This element contains the same value as GS08. Reference 98 SE Transaction Set Trailer
C.7 GS01 Functional Identifier Code ‘HN’ HN – Health Care Information Status Notification C.7 GS02 Application Sender Code PHC100680301406 Same value as ISA06. C.7 GS03 Application Receiver Code Same value as ISA08. C.8 GS04 Date Functional Group Creation Date in CCYYMMDD format C.8 GS05 Time Functional Group Creation Time in HHMM format C.8 GS06 Group Control Number Unique number within interchange. Will begin with 0001, and will be identical to GE02. C.8 GS07 Responsible Agency Code ‘X’ X - Accredited Standards Committee X12 C.8 GS08 Version/Release/Industry Identifier Code 005010X212 Version and transaction number C.9 GE Functional Group Trailer C.9 GE01 Number of Transaction Sets Include 1 Total number of transaction sets included in the functional group. C.9 GE02 Group Control Number Unique number assigned by the sender that must be identical to GS06. ST-SE Each real-time request should contain a single 276 Claim Status Request wrapped in a single STSE. TR3 Page # Reference Name Codes Expected Value 36 ST Transaction Set Header 36 ST01 Transaction Set Identifier Code 276 276 36 ST02 Transaction Set Control Number The Transaction Set Control Numbers in ST02 and SE02 must be identical. The number is assigned by the originator and must be unique within a functional group (GS-GE). 36 ST03 Implementation Convention Reference 005010X212 This element contains the same value as GS08. 98 SE Transaction Set Trailer