Claim edit: Missing claim-level place of service code

Stedi now rejects 837P professional and 837D dental claims that are missing a claim-level place of service code.

How the edit works

In a healthcare claim, a place of service code tells the payer where a service was delivered, such as an office or inpatient facility. Place of service codes can have a significant effect on how much a payer will approve or pay for a claim or service.

X12 standards require that 837P professional and 837D dental claims include a place of service code at the claim level. Place of service codes can also be specified at the service line level but should only be included if they differ from the claim-level code.

Claim-level place of service code

If a professional or dental claim is missing a claim-level place of service code, 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": "Missing Place of Service code. A place of service code is required for this claim. 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, and error message:

STC*A6>249*[DATE]*U*[AMOUNT]********Missing Place of Service code. A place of service code is required for this claim. Correct and resubmit.~