From 3bf56220103f63d07bdbef464055260aae54549b Mon Sep 17 00:00:00 2001 From: Nora Date: Thu, 2 Jul 2026 21:07:12 -0600 Subject: [PATCH] docs(sp33): update reference docs to CO_TXIX (per HCPF 837P Companion Guide) docs/reference/837p.md line 48: the CO Medicaid trading-partner line was still saying 'SKCO0 (sender) <-> COHCPF (receiver)'. The HCPF 837P Companion Guide (June 2025 - Version 2.5) requires NM1*PR NM109 = CO_TXIX; SKCO0 causes Gainwell to reject the SET ('2010BB NM109 must equal CO_TXIX or CO_BHA'). docs/reference/co-medicaid.md line 118 + the Trading Partner table at the top: same fix, with a pointer to the SP33 spec for the root-cause story. No code changes. Pure doc fix to match what the source now emits (PayerConfig.co_medicaid().payer_id = 'CO_TXIX'). --- docs/reference/837p.md | 2 +- docs/reference/co-medicaid.md | 11 +++++++---- 2 files changed, 8 insertions(+), 5 deletions(-) diff --git a/docs/reference/837p.md b/docs/reference/837p.md index 6bd0a99..b813648 100644 --- a/docs/reference/837p.md +++ b/docs/reference/837p.md @@ -45,7 +45,7 @@ full walker. ## CO Medicaid specifics -- Trading partner: `SKCO0` (sender) ↔ `COHCPF` (receiver) on `NM1*PR` / `NM1*40` +- Trading partners: `COMEDASSISTPROG` (NM1*40 NM109, 1000B receiver) and `CO_TXIX` (NM1*PR NM109, 2010BB payer). See `docs/goodclaim.x12` for a canonical example and the HCPF 837P Companion Guide for the full segment table. - `CLM05` is a composite of three components: place of service, facility code qualifier, and frequency code (in that order) - `CLM05-1` = place of service (any valid CMS POS code) diff --git a/docs/reference/co-medicaid.md b/docs/reference/co-medicaid.md index fc8dd26..4d77b69 100644 --- a/docs/reference/co-medicaid.md +++ b/docs/reference/co-medicaid.md @@ -9,11 +9,14 @@ Financing (HCPF) requires. | Role | 837P | 835 | |---|---|---| -| Sender | `SKCO0` | (varies; usually the clearinghouse) | -| Receiver | `COHCPF` | (varies) | +| Sender (submitter, `NM1*41`) | `Dzinesco` (TPID `11525703`) | (varies; usually the clearinghouse) | +| Receiver (`NM1*40`) | `COMEDASSISTPROG` | (varies) | +| Payer (`NM1*PR`) | `CO_TXIX` (per HCPF 837P Companion Guide) | (varies) | These appear in the `NM1*PR` (payer) and `NM1*40` (receiver) segments of -the 837P file. +the 837P file. The legacy codes `SKCO0` / `COHCPF` are no longer +accepted by Gainwell (HCPF error: "2010BB NM109 must equal CO_TXIX or +CO_BHA"); see [SP33](../superpowers/specs/2026-07-02-cyclone-co-txix-payer-fix-design.md). ## dzinesco's TPID (clearinghouse identity) @@ -115,7 +118,7 @@ ls -la "./var/sftp/staging/CO XIX/PROD/coxix_prod_11525703/ToHPE/" ### 837P (claims) -- `NM1*PR N104 = "SKCO0"` (COHCPF) +- `NM1*PR NM108 = "PI"`, `NM1*PR NM109 = "CO_TXIX"` (per HCPF 837P Companion Guide, June 2025 — Version 2.5). dzinesco submits against this code under dzinesco TPID `11525703`. The legacy trading-partner ID `SKCO0` is no longer accepted as the payer identifier. ### 835 (remittance)