New claim edits: Missing or invalid Payer Claim Control Number

Stedi now rejects 837P professional, 837D dental, and 837I institutional claims when the Payer Claim Control Number (PCCN) is missing when required – or included when it shouldn’t be.

A PCCN is the claim number the payer assigns after they receive and process a claim. It’s the payer’s unique ID for that claim.

You only include a PCCN when you’re replacing or voiding a previous claim. In those cases, payers use it to link the new claim to the original.

If a PCCN is included on a new claim – or missing when you’re replacing or voiding a previous claim – the payer may reject the claim. These edits catch those issues before your claim reaches the payer.

When the PCCN must be included
A claim’s Claim Frequency Code indicates whether it replaces or voids a previous claim. A PCCN is required if the frequency code is:

• 7 – Replacement of Prior Claim

• 8 – Void/Cancel of Prior Claim

• G – Common Working File (NCH) generated adjustment claim

• I – Miscellaneous adjustment claim

• X – Void/Cancel a Prior Abbreviated Encounter Submission

• Y –  Replacement of prior abbreviated encounter submission

If the PCCN is missing when one of these codes is used, Stedi rejects the claim using a new edit – an industry term for an automated validation rule.

If you submit a claim that fails the edit using Stedi’s claim submission APIs or professional claim form, you’ll get back an error message in real time. If you’re using a JSON API endpoint, the response includes details in the errors array:

{
  "errors": [
    {
      "code": "33",
      "description": "The Payer Claim Control Number is missing. This is required when submitting a replacement or void claim (Frequency code 7, 8, G, I, X, Y). Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit a claim that fails the edit using SFTP, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will contain a related claim status category code, claim status code, and error message. You can use the error message to correct and resubmit the claim.

When the PCCN must be excluded
If the Claim Frequency Code is not one of the codes above, you should not include a PCCN. If one is present, Stedi rejects the claim using a new edit.

If you submit a claim that fails the edit using Stedi’s claim submission APIs or professional claim form, you’ll get back an error message in real time. If you’re using a JSON API endpoint, the response includes details in the errors array:

{
  "errors": [
    {
      "code": "33",
      "description": "The Payer Claim Control Number should not be reported on this claim. This should only be used when submitting a replacement or void claim (Frequency code 7, 8, G, I, X, Y). Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit a claim that fails the edit using SFTP, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will contain a related claim status category code, claim status code, and error message. You can use the error message to correct and resubmit the claim.