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EDI 824 Format Example

EDI 824 Application Advice

What is EDI 824 Application Advice?

The X12 EDI 824 transaction set specified under HIPAA 5010 establishes the format and data contents of the Application Advice Transaction Set (824) for use within the context of an Electronic Data Interchange (EDI) environment. The 824 is used as a means of communicating errors in a previous transaction. This allows the trading partner who sent the original transaction to identify, correct and resubmit that transaction. The transaction set can be used to provide the capability to report the results of an application system’s data content edits of transaction sets.

X12 EDI 824 can report the inspection results of the previously sent transaction as any of the following:  Accepted, Rejected, Accepted with Changes, Partial Acceptance or Partial Rejection of any transaction set. The editing of the originating transaction sets can be reported at the functional group and transaction set level, in either coded or free-form format. The 824 is an Optional Transaction, currently not a HIPAA mandated transaction. 

In healthcare applications, the optional EDI 824 transaction meets HIPAA 5010 requirements for non-claims (276, 270 and 278) transactions. 

In practice, EDI 824 is also used as an acknowledgment to EDI 837 Claims. Many state health and wellness and/or Medicaid departments may require the use of EDI 824 Application Advice as a response from the receivers of inbound X12 EDI 837 Claims transactions under set conditions. (See each state’s Department of Health applicable Companion Guide for EDI 824 Application Advice.) 

Healthcare solution providers (e.g., CVS Caremark) also may require the use of EDI 824 in their trading partner acknowledgment specifications as an error reporting format for inbound EDI 837 Claims. 

The EDI 275 Attachment Acknowledgment in healthcare workflows may be a 999 and/or an 824. Using the 824 acknowledgment to report the success or failure of the attachment transaction may be preferred, as the 824 can embed the HL7 report indicating that the HL7 transaction was accepted or contained an HL7 syntax error.

Errors can cause the entire Functional Group (GS/GE) or entire Transaction Set (ST/SE) to be rejected, depending on the type of error, with no further processing. Since further processing is halted, the expected X12 response transaction may never be received (e.g., an 837 would not appear on an 835 remittance advice; a 271 would not be received in response to a 270; a 277 would not be received in response to a 276). 

Most, but not all, edit failures of these types will be reported using the 999 and/or 824 transactions. Generally, the 999 will report on acceptance/rejection at a high level. The 824 is used to supplement the 999 by providing very specific error information, data element by data element, allowing for easier analysis and correction. 

EDI 824 Application Advice doesn’t replace the EDI 997, EDI 999 or EDI TA1 transactions. The recipient of an 824 Application Advice document may send or be required to send a 997 Functional Acknowledgement in response. The 997 indicates that the 824 was successfully received. 

Note: EDI 824 should not be used in situations where a specific response document exists for a given transaction, e.g., EDI 835 Remittance Advice in response to an EDI 837 Healthcare Claim.

X12, chartered by the American National Standards Institute for more than 35 years, develops and maintains EDI standards and XML schemas.

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