Electronic claims submission changes coming to 'Billing Provider Address,' 'Loop 2010AA' under ANSI 5010

Beginning Jan. 1, 2012, all HIPAA-standard electronic transactions submitted by a covered entity* must be exchanged using the new ANSI v5010 standards. Please note the following major change regarding the requirement for how the Billing Provider Address must be submitted under ANSI v5010.

The new "implementation guides" for ANSI v5010, now known as Technical Reports Type 3 (TR3s), specify that:

  • "The Billing Provider Address must be a street address."
  • "P.O. Box or Lock Box addresses are to be sent in the Pay-to Address Loop (Loop ID-2010AB), if necessary."**

This change applies to all claim formats, i.e., Dental, Institutional and Professional (837D, 837I and 837P).

Electronic claims under ANSI v4010A1 submitted with a P.O. Box or Lock Box in the Billing Provider Address, Loop 2010AA, Segment N3 will soon begin to receive the Warning (W) message(s) listed below:

  • Message ID QCA – (Addr 1 – P.O. Box Not Allowed in ANSI v5010)
  • Message ID QCB – (Addr 2 – P.O. Box Not Allowed in ANSI v5010)

An announcement specifying when these warning messages will be implemented is forthcoming.

It is imperative that you heed these warning messages and begin submitting a physical address now, including a street number and name for the billing provider, along with the billing provider’s nine-digit Zip code. Under ANSI v5010, electronic claims submitted with the P.O. Box or Lock Box instead of a physical address for the Billing Provider Address will cause the claim to reject.

Please contact your IT staff, software vendor, billing service and/or clearinghouse to make sure they are aware of your electronic preferences and are making the necessary programming updates to your practice management system for compliance with the new ANSI v5010 standard.

If you have any questions regarding this notification, contact our Electronic Commerce Center at 800-746-4614.

Need more information about the ANSI v5010/ICD-10 conversion?

  • Visit the ANSI v5010/ICD-10 page in the Standards and Requirements section of our Provider website at bcbstx.com/provider.
  • Attend an ANSI v5010/ICD-10 Webinar! Click on the Education and Reference tab on our provider website and then click on Training to view the dates and times for upcoming ANSI 5010 / ICD-10 Webinars.
    Here's a direct link.
  • E-mail ANSI v5010 and ICD-10 questions to us at ansi_icd@bcbstx.com

* The definition of a covered entity includes health plans, health care clearinghouses, health information trading partners, health information networks, and health care providers.

** TR3s and TR3 Errata may be obtained through the Washington Publishing Company (WPC) at www.wpc-edi.com . The WPC is an independent third-party vendor that is solely responsible for its products and services.

BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent third-party vendors. If you have any questions regarding any of the products or services offered by a vendor, you should contact the vendor directly.