NUCC 1500 - 837P Crosswalk

Below is a link to the NUCC 1500 - 837P Crosswalk.

The NUCC's 1500 Claim Form Map to the X12N Health Care Claim: Professional (837) is a simplified map of the 1500 Item Number fields to the corresponding data elements in the 837P 5010/5010A1 transaction. This document is intended to be used in conjunction with the NUCC Data Set; however the NUCC Data Set will not be updated until the completion of the revisions to the 1500 form.

Users of the 1500 - 837P Crosswalk will need to refer to the NUCC's 1500 Reference Instruction Manual for mre specific information on the 1500 Claim Form and the X12N Health Care Claim: Professional 5010/5010A1 implementation guide for more information on the electronic transaction.

 

NUCC Data Set

Below is a link to the NUCC Data Set.

The NUCC Data Set is a compilation of each data element in the 837P and its relationship to the 1500 Claim Form Item Numbers. The NUCC Data Set was previously released in 2003. It has been revised to accommodate the changes to the 08/05 version of the 1500 Claim Form.

Users of the NUCC Data Set will need to refer to the NUCC’s 1500 Reference Instruction Manual for more specific information on the 1500 Claim Form and the X12 837 Health Care Claim: Professional 4010A1 implementation guide for more information on the electronic transaction.

Background

NUCC Data Set

Several principles underlie the NUCC’s goals and implementation approach, including:

  • Standardization requires broad-based consensus among key parties. The NUCC is a broad, public and private-sector collaboration governed by formal Bylaws.
  • Data sets for institutional and professional (non-institutional) claims/encounters must be coordinated. To foster coordination the NUCC works closely with the NUBC.
  • The professional (non-institutional) uniform data set and associated attachments requirements should constitute the full extent of the data required by any public or private payer to process a claim/encounter.

The end product of the NUCC’s efforts is one standard data set, with complete and unambiguous data definitions, for use in the electronic environment, but applicable to and consistent with evolving paper claim form standards.

The NUCC will continue to work to optimize, as necessary, coordination of implementation within the health care industry, working with ASC X12 as required, to resolve data maintenance and standards issues between the electronic claim transaction and the 1500 Claim Form. Consistency between the outputs of the NUCC and ASC X12 will be emphasized, as well as consistency between the NUCC and NUBC.

Requests for changes to the NUCC Data Set may be submitted via email to This email address is being protected from spambots. You need JavaScript enabled to view it..