Claim edit: ZIP or postal code not allowed outside the U.S. and Canada

Stedi now rejects 837P professional, 837D dental, and 837I institutional claims that include a ZIP or postal code in an address outside the U.S. or Canada.

How the edit works

X12 states that ZIP and postal code fields are specific to the U.S. and Canada. If an address in a claim has a country code other than US or CA, it should not contain a ZIP or postal code. If it does, the payer may reject the claim.

This edit catches the issue before the claim reaches the payer. It prevents payer rejections, which take longer to resolve and delay payment for the provider.

Rejection errors

If you submit a claim using Stedi's Claim Submission API endpoints and the claim fails the edit, you'll get back an error response in real time. The response includes details in the errors array:

{
  "errors": [
    {
      "code": "33",
      "description": "Invalid postal code usage. A ZIP Code must only be submitted when the country is US or CA. The submitted address for Subscriber includes a ZIP Code with country code FR. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

{
  "errors": [
    {
      "code": "33",
      "description": "Invalid postal code usage. A ZIP Code must only be submitted when the country is US or CA. The submitted address for Subscriber includes a ZIP Code with country code FR. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

{
  "errors": [
    {
      "code": "33",
      "description": "Invalid postal code usage. A ZIP Code must only be submitted when the country is US or CA. The submitted address for Subscriber includes a ZIP Code with country code FR. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit a claim using SFTP and the claim fails the edit, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will include a related claim status category code, claim status code, entity identifier code, and error message:

STC*A7>500>HK*[DATE]*U*[AMOUNT]******A8>680>HK**Invalid postal code usage. A ZIP Code must only be submitted when the country is US or CA. The submitted address for Subscriber includes a ZIP Code with country code FR. Correct and resubmit

STC*A7>500>HK*[DATE]*U*[AMOUNT]******A8>680>HK**Invalid postal code usage. A ZIP Code must only be submitted when the country is US or CA. The submitted address for Subscriber includes a ZIP Code with country code FR. Correct and resubmit

STC*A7>500>HK*[DATE]*U*[AMOUNT]******A8>680>HK**Invalid postal code usage. A ZIP Code must only be submitted when the country is US or CA. The submitted address for Subscriber includes a ZIP Code with country code FR. Correct and resubmit