Claim edit: Missing country code for non-US addresses

Stedi now rejects 837P professional, 837D dental, and 837I institutional claims that include a non-US address without a country code.

How the edit works

HIPAA-adopted X12 EDI standards require a country code when any address in a claim is outside the United States.

If an address's state or province code is not a US state or territory, the address must include a country code. If the country code is missing from a non-US address, the payer may reject the claim.

If the country code for a non-US address in a claim is missing, Stedi attempts to look up the country code using the full address. If successful, Stedi then updates the claim.

For example, if a billing provider’s address lists a state/province code of ON (Ontario) and uses a Canadian postal code format, Stedi will automatically add a country code of CA (Canada).

If Stedi's lookup can't find the country code, this edit rejects the claim. It prevents payer rejections, which are slower 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.

The entity name in the error varies based on which address in the claim is missing the country code. For example, the following error indicates the billing provider's address is missing a country code:

{
  "errors": [
    {
      "code": "33",
      "description": "Missing Country Code. The country code for Billing Provider is required when the address is outside the United States. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

{
  "errors": [
    {
      "code": "33",
      "description": "Missing Country Code. The country code for Billing Provider is required when the address is outside the United States. Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

{
  "errors": [
    {
      "code": "33",
      "description": "Missing Country Code. The country code for Billing Provider is required when the address is outside the United States. 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, entity identifier code, and error message:

STC*A6>680>85*[DATE]*U*[AMOUNT]********Missing Country Code. The country code for Billing Provider is required when the address is outside the United States. Correct and resubmit

STC*A6>680>85*[DATE]*U*[AMOUNT]********Missing Country Code. The country code for Billing Provider is required when the address is outside the United States. Correct and resubmit

STC*A6>680>85*[DATE]*U*[AMOUNT]********Missing Country Code. The country code for Billing Provider is required when the address is outside the United States. Correct and resubmit