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Novitas Solutions (MAC J-H/J-L) · Health Care Claim — Institutional

Implementation notes for feeding the 837I transaction to Novitas Solutions (MAC J-H/J-L).

Envelope defaults

{
  "isaSenderQualifier": "ZZ",
  "isaReceiverQualifier": "ZZ",
  "receiverId": "12M52",
  "versionId": "005010X223A2",
  "gsCode": "HC",
  "usageIndicator": "P"
}

Required fields

  • REF/REF02 — Medicare PTAN (REF*G2) at 2010AA

Fixed values

  • GS08 = 005010X223A2 — Novitas institutional requires 5010 A2 addenda