Claim edit: Missing service date on dental claims
Stedi now rejects 837D dental claims that are missing a claim-level service date, unless the claim is for a predetermination of benefits.
How the edit works
Most dental claims report services a provider has already performed. The claim-level service date tells the payer when those services took place.
Service date
| Claim type | JSON API field | X12 element |
|---|---|---|
| 837D dental | claimInformation.claimDateInformation.serviceDate | DTP*472 (Service Date) of Loop 2300 (Claim Information) |
X12 standards require dental claims to include a claim-level service date unless the claim is for a predetermination of benefits. A date on an individual service line doesn't satisfy the requirement.
A predetermination of benefits claim works differently. It asks what a payer would cover before service occurs, so there's no service date to report.
Predetermination of benefits
| Claim type | JSON API field | X12 element |
|---|---|---|
| 837D dental | claimInformation.predeterminationOfBenefits | CLM-19 (Predetermination of Benefits Code) of Loop 2300 (Claim Information) |
If a dental claim isn't for a predetermination of benefits and has no claim-level service date, 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 Service Date. The claim-level date of service is required unless the claim is a predetermination of benefits (CLM19 = PB). 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>187*[DATE]*U*[AMOUNT]********Missing Service Date. The claim-level date of service is required unless the claim is a predetermination of benefits (CLM19 = PB). Correct and resubmit.~