Electronic Data Interchange (EDI)

Published 07/12/2022

Palmetto GBA's Electronic Data Interchange (EDI) division encourages providers to submit their claims electronically and to utilize certain electronic features we offer. You can also access certain claim and patient eligibility records, and retrieve your remittance notices electronically.

The Centers for Medicare & Medicaid Services (CMS) has approved version 5010 Base and Errata as the exclusive version for all ASC X12N electronic transaction sets used by Medicare. ASC X12 TR3 Implementation Guides for v5010 transactions are available through the ASC X12 Store.

Please contact the Palmetto GBA Provider Contact Center toll-free at 877–567–7271 for EDI-related assistance. You may also email us by clicking on Contact Us at the top of this page.

How to Avoid Common Version 5010 Claims RejectionsHealth Care Provider Taxonomy Codes (HPTC) InformationPart A & HHH PC-ACE Pro32 Reference GuideTraining Modules on v5010 ReportsNetwork Service AgreementNetwork Service Vendors (NSVs) for JJDirect Date Entry (DDE) Security EmailsJJ Part A Approved 5010 Errata VendorsCMS-1450 Claim Form Crosswalk to ASC X12 837I v5010A2PC-ACE Pro32 Software User Manual999 and 277CA Response ReportsClaim Status Category Code and Claim Status Code UpdateOnline ERA /ERN and GPNet Report Restore FormIntroduction to PC-ACE Pro32ASC X12 270/271 Beneficiary Eligibility InquiriesASC X12 v5010 Medicare Fee-For-Service Standard Companion GuidesPC-ACE Pro32 Training ModulesGPNet Communications ManualEDI Enrollment Status ToolASC X12 v5010 Resources At-A-GlanceASC X12 837 v5010 Errata Testing ProceduresDDE User's GuideMedicare Secondary Payer (MSP) Part A Electronic Claim Filing RequirementsPart A Electronic Claim TipsJurisdiction J Part A EDI Enrollment PacketInformation to Have Available When Contacting the EDI DepartmentEDI Enrollment Instructions Guide ModuleDirect Data Entry (DDE) IDs, Access and Security Measures, and Password ProceduresJJ Part A EDI Online Enrollment FormsProvider Alert: Discontinuation of Common Working File Eligibility TransactionsPC-ACE Pro32 Version 5.3 Update FileReason Code 10420Reason Code 15431Reason Code 19201Reason Code 19301Reason Code 30906Reason Code 30949Reason Code 31014Reason Code 31102Reason Code 31300Reason Code 31337Reason Code 31409Reason Code 31600Reason Code 31860Reason Code 32114Reason Code 32242Reason Code 32352Reason Code 32415Reason Code 34538Reason Code 34905Reason Code 34932Reason Code 34961Reason Code 34977Reason Code 34978Reason Code 37541Reason Code 37544Reason Code 38032Reason Code 39910Reason Code 39934Reason Code 52MUEReason Code 53MUEReason Code C7252Reason Code 70024Reason Code C7113Reason Code C7715Reason Code C7800Reason Code U5061Reason Code U6819Reason Code W7006Reason Code W7062Reason Code W7088Reason Code W7099Reason Code W7112Reason Code 5D508Reason Code U6825Reason Code U6805Reason Code 31259Reason Code 55503Reason Code 38119Reason Code 32404Reason Code 31398Reason Code 31413Reason Code 32078Reason Code 30912Reason Code 31593Reason Code 19401Reason Code 31094Reason Code 14610Reason Code 38117Reason Code 31256Reason Code 31023Reason Code 32073Reason Code 31255Reason Code U5607Reason Code U5233Reason Code 15701Reason Code 31608Reason Code C7080Reason Code 12205Reason Code 30955Reason Code 30905Reason Code 11503Reason Code 12505Reason Code 17701Reason Code 31605Reason Code 13599Reason Code 12818Reason Code 31346Reason Code 13314Reason Code 1461AReason Code 31406Reason Code 31486Reason Code C7010Reason Code 31257Reason Code 30949Reason Code 12302Reason Code 12206Reason Code 12811Reason Code 15202Reason Code 37205Reason Code W7040Reason Code 39132Reason Code 54NCDReason Code 51MUEReason Code U5210Reason Code 31241Reason Code U5200Reason Code 30940Reason Code 38038Reason Code 38200Reason Code 39929Reason Code 53NCDReason Code 31814Reason Code 32402Reason Code 39011Reason Code 31947Reason Code 31324Reason Code 30928Reason Code 31276Reason Code 31689Reason Code 32105Reason Code 32400Reason Code 56900JJ Part A Annual DDE Recertification277CA Edit Lookup ToolSmart Edits Listing and 277CA EnhancementPC-ACE Pro32 Version 5.4 Update FilePC-ACE Pro32 Software Download for JJ Part APC Print Software and User's ManualJJ Part A EDI Enrollment: Finding Forms OnlineWhat information do I need to have available when calling for Electronic Data Interchange (EDI) assistance?Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description?What provider address should I include on the EDI enrollment forms?What Submitter Name should I enter on the Provider Authorization form?What is a Network Service Vendor?When is a provider authorization form required?What PTAN should I enter on the EDI enrollment forms if the provider is a member of a group?What is the difference between a Submitter ID and a DDE ID?What is an approved software vendor?Is the 277CA returned for each test submission?Is the Submitter ID required on the DDE enrollment form?PC-ACE Pro32 Software FAQHow do I restore a remit file?If I have an existing DDE ID with another company, can I request a new ID?How do I reset my DDE password?Can I share my DDE ID?How can I tell if I am set up for Electronic Billing?After I receive a 277CA will I receive anything else?Reason Code 1282HPC-ACE Pro32 Version 5.5 Update File