Claim edit: Missing patient control number

Stedi now rejects 837P professional, 837D dental, and 837I institutional claims that don't include a patient control number.

Patient control numbers

A patient control number (PCN) is the tracking ID submitters assign to a claim when they submit it. The payer returns the PCN in follow-up transactions – 277CA claim acknowledgments, Electronic Remittance Advice (ERAs), and claim status checks. You use the PCN to match each response to the original claim.

Patient control number

How the edit works

X12 standards require a PCN on every claim. If you submit a claim without a PCN, 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 Patient Control Number. A patient control number is required and must be 20 characters or fewer. 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>481*[DATE]*U*[AMOUNT]********Missing Patient Control Number. A patient control number is required and must be 20 characters or fewer. Correct and resubmit.~

Related claim edits

Stedi has another edit for PCNs longer than 20 characters. See Invalid patient control number.