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EDI Front End Rejection Code Lookup Tool

To view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code information in the appropriate form field then select Submit.

  • CSCC – Claim Status Category Code (required): This code indicates the general category of the status (e.g., accepted, rejected, additional information requested), which is further detailed in the CSC element.
  • CSC – Claim Status Code (required): This code conveys the status of an entire claim or a specific service line.
  • EIC – Entity Identifier Code (when applicable): These are unique codes used to identify an entity (e.g., organization, facility, provider, physical location, individual).

Note: This edit tool is for Part A specific edit descriptions only. If you are trying to view Part B edit explanations, please return to the NGS home page (click on the NGS logo) and sign in as a Guest, using ‘I am a Part B Provider’ and follow the prompts.

EDI Front End Rejection Code Lookup Tool
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Additional 5010 Resources

  • Companion Document for 5010 Transactions: The standard companion guide trading partner information which provides instructions related to transactions based on ASC X12 Implementation Guides, version 005010.
  • Medicare Fee-for-Service 5010 - D0: Access CMS 5010 technical documentation, including the 5010 Institutional and Professional Edits spreadsheets, located under the Downloads section of the page.
  • Washington Publishing Company (WPC): This website offers a complete listing of all Medicare-related 5010 code sets as well as an array of reference publications and resources.
  • 5010 Implementation Guides: ASC X12 offers HIPAA 5010 implementation guides in various formats (downloadable PDF, PDF on CD, bound books and table data) through its online store.

 

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