276 Health Care Claim Status Request (004010X093A1)
Providers send the 276 to ask a payer for the status of claims they submitted. This is the standard X12 HIPAA 004010 spec, with 14 loops and 35 segment positions, as OpenEDI JSON, an ediFabric C# template and an ediFabric Native model. To change it for a trading partner, customize it in the EDI Spec Builder.
Use the 276 spec in your code
ediFabric .NET
Add the C# template and its common files to your project, or reference the template NuGet package, and read 276 files into TS276 objects. See ediFabric .NET.
ediFabric Native
Map version 004010X093A1 to the Native model with set_map, then parse 276 files to JSON from Python, Java, C or C#. See Convert between EDI and JSON.
OpenEDI
Select Customize in Spec Builder to copy the spec under your own name, change it for your partner, and parse files against it in EdiNation, ediFabric Native or ediFabric Cloud. Read about OpenEDI.
Generate 276 classes in Python, Java, Node.js, Go, Rust or C
ediFabric Native returns each 276 as JSON, with the property names of the OpenEDI schema. To work with that JSON as typed objects, generate classes from the OpenEDI file in your language and deserialize the JSON into TS276. Serialize the objects back to JSON to build EDI with ediFabric Native. The classes keep the loops, segments, lengths and code lists, but not the EDI data formats, so validate files with ediFabric Native. Read more in Generate a class from OpenEDI.
Python: datamodel-code-generator. Node.js: openapi-typescript. Java, Go, Rust and C: OpenAPI Generator.
For a sample file, the same data as JSON, and code to parse, validate and generate the 276, see the 276 transaction guide.
276 structure
Loops and segments of the standard 276, with their usage and maximum repeats.
| ID | Name | Usage | Max use |
|---|---|---|---|
| ST | Transaction Set Header | Optional | 1 |
| BHT | Beginning Of Hierarchical Transaction | Mandatory | 1 |
| Loop HL | Information Source Level | Mandatory | >1 |
| HL | Information Source Level | Mandatory | 1 |
| Loop NM1 | Payer Name | Mandatory | >1 |
| NM1 | Payer Name | Mandatory | 1 |
| PER | Payer Contact Information | Optional | 1 |
| Loop HL | Information Receiver Level | Mandatory | >1 |
| HL | Information Receiver Level | Mandatory | 1 |
| Loop NM1 | Information Receiver Name | Mandatory | >1 |
| NM1 | Information Receiver Name | Mandatory | 1 |
| Loop HL | Service Provider Level | Mandatory | >1 |
| HL | Service Provider Level | Mandatory | 1 |
| Loop NM1 | Provider Name | Mandatory | >1 |
| NM1 | Provider Name | Mandatory | 1 |
| Loop HL | Subscriber Level | Mandatory | >1 |
| HL | Subscriber Level | Mandatory | 1 |
| DMG | Subscriber Demographic Information | Optional | 1 |
| Loop NM1 | Subscriber Name | Mandatory | 1 |
| NM1 | Subscriber Name | Mandatory | 1 |
| Loop TRN | Claim Submitter Trace Number | Optional | >1 |
| TRN | Claim Submitter Trace Number | Mandatory | 1 |
| REF | Payer Claim Identification Number | Optional | 1 |
| REF | Institutional Bill Type Identification | Optional | 1 |
| REF | Medical Record Identification | Optional | 1 |
| REF | Group Number | Optional | 1 |
| AMT | Claim Submitted Charges | Optional | 1 |
| DTP | Claim Service Date | Optional | 1 |
| Loop SVC | Service Line Information | Optional | >1 |
| SVC | Service Line Information | Mandatory | 1 |
| REF | Service Line Item Identification | Optional | 1 |
| DTP | Service Line Date | Mandatory | 1 |
| Loop HL | Dependent Level | Optional | >1 |
| HL | Dependent Level | Mandatory | 1 |
| DMG | Dependent Demographic Information | Mandatory | 1 |
| Loop NM1 | Dependent Name | Mandatory | 1 |
| NM1 | Dependent Name | Mandatory | 1 |
| Loop TRN | Claim Submitter Trace Number | Mandatory | >1 |
| TRN | Claim Submitter Trace Number | Mandatory | 1 |
| REF | Payer Claim Identification Number | Optional | 1 |
| REF | Institutional Bill Type Identification | Optional | 1 |
| REF | Medical Record Identification | Optional | 1 |
| AMT | Claim Submitted Charges | Optional | 1 |
| DTP | Claim Service Date | Optional | 1 |
| Loop SVC | Service Line Information | Optional | >1 |
| SVC | Service Line Information | Mandatory | 1 |
| REF | Service Line Item Identification | Optional | 1 |
| DTP | Service Line Date | Optional | 1 |
| SE | Transaction Set Trailer | Optional | 1 |