Implementation acknowledgement 999 - format and examples

ISA
	GS - 837
		ST
			*837*0001
		SE
		ST
			*837*0002
		SE
	GE
	
        
        

       GS - 837
		ST
			*837*0001
		SE
	GE
IEA

ISA
   GS – 999
     ST
       AK1(AK102 equals GS06 in the functional group being acknowledged)
       AK2 (AK202 equals ST02 in the transaction set being acknowledged)
       IK5
       AK2 (AK202 equals ST02 . . .)
       IK5
       AK9
     SE
   GE
   GS
     ST
       AK1 (AK102 equals GS06 . . .)
       AK2 (AK202 equals ST02 . . .)
       IK5
       AK9
      SE
    GE
 IEA

The most important segments, for troubleshooting purposes, in an implementation acknowledgement file are the following:

IK3

Segment IK3 in 999 implementation acknowledgement files identifies the location of errors in the transaction segment. Multiple IK3 segments can display if the transaction set contains multiple errors.

CTX

Segment CTX in 999 implementation acknowledgement files is used for the following:

• When a syntax error occurs within a business unit, the CTX segment identifies the business unit (such as the patient control number for a claim) that generated the error.

• When a syntax error is triggered by a situational requirement, the CTX segment identifies the data element that triggered the situational requirement.

IK4

Segment IK4 in 999 implementation acknowledgement files identifies the data element, or field, in the transaction set that is in error. Multiple IK4 segments can display if multiple transaction sets have data elements in error.

IK5

Segment IK5 in 999 implementation acknowledgement files identifies the status of a transaction set in the transmission file whether or not it contains errors. Multiple IK5 segments are associated with a single AK9 segment if the transmission file contains more than one transaction set in the associated functional group.

AK9

Segment AK9 in 999 acknowledgement files identifies the status of the functional group in the transmission file. A single AK9 segment has multiple IK5 segments associated with it if the functional group in the transmission file includes more than one transaction set.

More information about how to interpret these segments is available in the topics that follow. Detail implementation specifications for the 999 Implementation Acknowledgement can also be found in the Implementation Acknowledgment For Health Care Insurance.

As shown in the following examples, the 999 transaction is intended to be imported into an automated system such as an EDI X12N compatible practice management system, and therefore is not formatted for human readability. A human-readable version is provided by the 99T format.

ISA*00*     *00*     *01*030240928   *ZZ*AV09311993*031204*1109*U*00501*000090091*0*P*:~
TA1*000001732*031204*1101*A*000~
GS*FA*030240928*AV01101957*20031204*1109*80180*X*005010X231A1~
ST*999*0001*005010X231A1~
AK1*HC*17321*005010X223A2~
AK2*837*000000001*005010X223A2~
IK3*CL1*24*2300*8~
CTX*CLM01:393931D_1310~
IK4*2*1314*5*AA~
IK5*R*5~
AK9*R*1*1*0~
SE*8*0001~
GE*1*80180~
IEA*1*000090091~

ISA*00*     *00*     *01*030240928   *ZZ*AV09311993*030306*1356*U*00501*000000000*0*P*:~
GS*FA*030240928*AV01101957*20030306*1356*000000000*X*005010X231A1~
ST*999*000000000*005010X231A1~
AK1*HC*103136*005010X222A1~
AK2*837*000003136*005010X222A1~
IK5*A~
AK9*A*1*1*1~
SE*6*000000000~
GE*1*000000000~
IEA*1*000000000~