277 Health Care Claim Status Response (004010X093A1)

Payers return the 277 in reply to a 276, with the status of each claim asked about. This is the standard X12 HIPAA 004010 spec, with 14 loops and 36 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.

Loading the spec…
The spec as an OpenAPI 3 schema with x-openedi-* extensions, for ediFabric Native, ediFabric Cloud and the EDI Spec Builder. Download OpenEDI (69 KB) Generate classes
The ediFabric .NET template, class TS277. The download includes the common segments, composites and codes it needs. Download C# (52 KB)
The intermediary model ediFabric Native loads with set_map. Download Native (33 KB)

Use the 277 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 277 files into TS277 objects. See ediFabric .NET.

ediFabric Native

Map version 004010X093A1 to the Native model with set_map, then parse 277 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 277 classes in Python, Java, Node.js, Go, Rust or C

ediFabric Native returns each 277 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 TS277. 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 277, see the 277 transaction guide.

277 structure

Loops and segments of the standard 277, with their usage and maximum repeats.

IDNameUsageMax use
STTransaction Set HeaderOptional1
BHTBeginning Of Hierarchical TransactionMandatory1
Loop HLInformation Source LevelMandatory>1
HLInformation Source LevelMandatory1
Loop NM1Payer NameMandatory>1
NM1Payer NameMandatory1
PERPayer Contact InformationOptional1
Loop HLInformation Receiver LevelMandatory>1
HLInformation Receiver LevelMandatory1
Loop NM1Information Receiver NameMandatory>1
NM1Information Receiver NameMandatory1
Loop HLService Provider LevelMandatory>1
HLService Provider LevelMandatory1
Loop NM1Provider NameMandatory>1
NM1Provider NameMandatory1
Loop HLSubscriber LevelMandatory>1
HLSubscriber LevelMandatory1
DMGSubscriber Demographic InformationOptional1
Loop NM1Subscriber NameMandatory1
NM1Subscriber NameMandatory1
Loop TRNClaim Submitter Trace NumberOptional>1
TRNClaim Submitter Trace NumberMandatory1
STCClaim Level Status InformationMandatory1
REFPayer Claim Identification NumberOptional1
REFInstitutional Bill Type IdentificationOptional1
REFMedical Record IdentificationOptional1
DTPClaim Service DateOptional1
Loop SVCService Line InformationOptional>1
SVCService Line InformationMandatory1
STCService Line Status InformationOptional1
REFService Line Item IdentificationOptional1
DTPService Line DateOptional1
Loop HLDependent LevelOptional>1
HLDependent LevelMandatory1
DMGDependent Demographic InformationMandatory1
Loop NM1Dependent NameMandatory1
NM1Dependent NameMandatory1
Loop TRNClaim Submitter Trace NumberMandatory>1
TRNClaim Submitter Trace NumberMandatory1
STCClaim Level Status InformationMandatory1
REFPayer Claim Identification NumberMandatory1
REFInstitutional Bill Type IdentificationOptional1
REFMedical Record IdentificationOptional1
DTPClaim Service DateOptional1
Loop SVCService Line InformationOptional>1
SVCService Line InformationMandatory1
STCService Line Status InformationOptional1
REFService Line Item IdentificationOptional1
DTPService Line DateOptional1
SETransaction Set TrailerOptional1