FIX: An HIPAA 837 document that has noncompliant NM108 and NM109 data elements is not validated as expected in BizTalk Server 2006 R2

Consider the following scenario:

• You use Microsoft BizTalk Server 2006 R2 to receive Health Insurance Portability and Accountability Act (HIPAA) messages.
• You receive an 837 Professional document.
• In the 837 Professional document, in 2010BA loop, one of the NM108 or NM109 data elements contains a value. However, the other data element is empty.

In this scenario, the 837 Professional document passes validation. However, HIPAA requires that if one of the NM108 or NM109 data elements has a value, both values must be present. This problem can affect the compliance of your HIPAA data.
This problem also occurs when you work with 837 Institutional documents and 837 Dental documents.

This problem occurs because the X12ConditionDesignator_Check attribute is disabled in the 837 HIPAA schema files. When the X12ConditionDesignator_Check attribute is disabled, the cross field validation does not work correctly. Therefore, the 837 documents that have invalid NM108 or NM109 data elements in 2010BA loop still pass validation.

Hotfix information

A supported hotfix is available from Microsoft. However, this hotfix is intended to correct only the problem that is described in this article. Apply this hotfix only to systems that are experiencing this specific problem.

If the hotfix is available for download, there is a "Hotfix download available" section at the top of this Knowledge Base article. If this section does not appear, submit a request to Microsoft Customer Service and Support to obtain the hotfix.

Note If additional issues occur or if any troubleshooting is required, you might have to create a separate service request. The usual support costs will apply to additional support questions and issues that do not qualify for this specific hotfix. For a complete list of Microsoft Customer Service and Support telephone numbers or to create a separate service request, visit the following Microsoft Web site: Note The "Hotfix download available" form displays the languages for which the hotfix is available. If you do not see your language, it is because a hotfix is not available for that language.

Prerequisites

You must have BizTalk Server 2006 R2 installed to apply this hotfix.

Restart requirement

You do not have to restart the computer after you apply this hotfix.

Hotfix replacement information

This hotfix does not replace a previously released hotfix.

File information

The English version of this hotfix has the file attributes (or later file attributes) that are listed in the following table. The dates and times for these files are listed in Coordinated Universal Time (UTC). When you view the file information, it is converted to local time. To find the difference between UTC and local time, use the Time Zone tab in the Date and Time item in Control Panel.Note Because of file dependencies, the most recent hotfix that contains these files may also contain additional files.This hotfix includes a new set of HIPAA schemas. After you install this hotfix, you can find the Microsoftedixsdtemplateskb957512.exe file in the following folder:



This hotfix contains updated schemas. Double-click this compressed file to unzip it. However, be aware that if you unzip the file to the same directory as the existing schemas, the existing schemas may be overwritten.

To work around this problem, you can manually enable the X12ConditionDesignator_Check attribute in the HIPAA schema files. To do this, follow these steps:

1. Open the 837 schema in a text editor, such as Notepad.
2. Locate the X12ConditionDesignator_Check attribute.
3. Change the value from "No" to "Yes"
4. Save and redeploy the schema.

Microsoft has confirmed that this is a problem in the Microsoft products that are listed in the "Applies to" section.

After you apply the hotfix, when you receive an 837 document, if only the NM108 data element is specified and the NM109 data element is not in 2010BA loop, or vice versa, the document is suspended correctly. Additionally, you will receive an Application event log that resembles the following:

For more information about BizTalk Server 2006 R2 Electronic Data Interchange (EDI) tutorials, visit the following Microsoft Web site:
For more information about software update terminology, click the following article number to view the article in the Microsoft Knowledge Base: