Medicare Claims Processing Manual (Pub. 100-04), Ch. 24 § 50.3.3.1
Outbound File Compliance Check
50.3.3.1 - Outbound File Compliance Check
(Rev. 2803, Issued: 10-28-13, Effective: 09-17-13, Implementation: 09-17-13)
The ASC X12 999 implementation acknowledgment, the ASC X12 835 remittance
advice, ASC X12 276/277 claim status response and the ASC X12 277CA claim
acknowledgment outbound files shall be compliance checked for the following:
• Basic syntactical integrity and specific syntax requirements on all outbound files;
• Balanced field totals, financial balancing of claims or remittance advices, and
balancing of summary fields, if appropriate for all outbound file;
• Specific inter-segment situations described in the HIPAA Implementation Guides
for all outbound files; and
• Valid TR3 specific code set values and other code sets adopted as HIPAA
standards for all outbound files.