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Segment
in
X12 Release 004020

STC Status Information

To report the status, required action, and paid information of a claim or service line
Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
C043
Health Care Claim Status
Composite (composite)
Mandatory
01
Industry Code
String (AN)
Mandatory
1
30
-
Code indicating a code from a specific industry code list
C043-01 is used to specify the logical groupings of Health Care Claim Status Codes (See Code Source 507).
02
Industry Code
String (AN)
Mandatory
1
30
-
Code indicating a code from a specific industry code list
C043-02 is used to identify the status of an entire claim or a serviceline. Code Source 508 is referenced unless qualified by C043-04.
03
Entity Identifier Code
Identifier (ID)
Optional
2
3
-
Code identifying an organizational entity, a physical location, property or an individual
C043-03 identifies the entity associated with the Health Care Claim Status Code.
Codes (1393)
04
Code List Qualifier Code
Identifier (ID)
Optional
1
3
-
Code identifying a specific industry code list
C043-04 is used to identify the Code Source referenced in C043-02.
Codes (624)
02
Date
Date (DT)
Optional
8
8
-
Date expressed as CCYYMMDD
STC02 is the effective date of the status information.
03
Action Code
Identifier (ID)
Optional
1
2
-
Code indicating type of action
Codes (308)
04
Monetary Amount
Decimal number (R)
Optional
1
18
-
Monetary amount
STC04 is the amount of original submitted charges.
05
Monetary Amount
Decimal number (R)
Optional
1
18
-
Monetary amount
STC05 is the amount paid.
06
Date
Date (DT)
Optional
8
8
-
Date expressed as CCYYMMDD
STC06 is the paid date.
07
Payment Method Code
Identifier (ID)
Optional
3
3
-
Code identifying the method for the movement of payment instructions
Codes (50)
08
Date
Date (DT)
Optional
8
8
-
Date expressed as CCYYMMDD
STC08 is the check issue date.
09
Check Number
String (AN)
Optional
1
16
-
Check identification number
10
Health Care Claim Status
Composite (composite)
Optional
01
Industry Code
String (AN)
Mandatory
1
30
-
Code indicating a code from a specific industry code list
C043-01 is used to specify the logical groupings of Health Care Claim Status Codes (See Code Source 507).
02
Industry Code
String (AN)
Mandatory
1
30
-
Code indicating a code from a specific industry code list
C043-02 is used to identify the status of an entire claim or a serviceline. Code Source 508 is referenced unless qualified by C043-04.
03
Entity Identifier Code
Identifier (ID)
Optional
2
3
-
Code identifying an organizational entity, a physical location, property or an individual
C043-03 identifies the entity associated with the Health Care Claim Status Code.
Codes (1393)
04
Code List Qualifier Code
Identifier (ID)
Optional
1
3
-
Code identifying a specific industry code list
C043-04 is used to identify the Code Source referenced in C043-02.
Codes (624)
11
Health Care Claim Status
Composite (composite)
Optional
01
Industry Code
String (AN)
Mandatory
1
30
-
Code indicating a code from a specific industry code list
C043-01 is used to specify the logical groupings of Health Care Claim Status Codes (See Code Source 507).
02
Industry Code
String (AN)
Mandatory
1
30
-
Code indicating a code from a specific industry code list
C043-02 is used to identify the status of an entire claim or a serviceline. Code Source 508 is referenced unless qualified by C043-04.
03
Entity Identifier Code
Identifier (ID)
Optional
2
3
-
Code identifying an organizational entity, a physical location, property or an individual
C043-03 identifies the entity associated with the Health Care Claim Status Code.
Codes (1393)
04
Code List Qualifier Code
Identifier (ID)
Optional
1
3
-
Code identifying a specific industry code list
C043-04 is used to identify the Code Source referenced in C043-02.
Codes (624)
12
Free-Form Message Text
String (AN)
Optional
1
264
-
Free-form message text
STC12 allows additional free-form status information.
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Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.