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X12 Forms a New Code Maintenance Group

The X12 External Code List Oversight (ECO) Subcommittee, operating under X12's Registered Standards Committee (RSC), is responsible for the integrity and efficiency of X12's external code lists and oversight of external code list maintenance. The ECO is currently forming a new code maintenance group. This new group, the Health Care Services Code Maintenance Group (CMG04), will be responsible for maintaining code lists related to health care services.

The code lists maintained by CMG04 are used in various health care messages, for example in X12's 270, 271, and 278 transactions. The CMG04 maintained code lists are multi-functional, describing benefits and communicating about service review outcomes.

The code lists assigned to the group include:

  • Health Care Services Decision Reason Codes (886) – these codes communicate the reason for a health care services review outcome
  • Service Type Codes (958) – these codes identify business groupings for health care services or benefits

CMG04 will operate under a defined representative voting panel methodology. This means the group's constituents will be explicitly identified to ensure the broad interests of the various implementers of the associated transactions and users of the codified information are represented. The CMG04 constituents will represent both administrative and clinical interests.

Organizations such as the ADA, AMA, AHA, BCBSA, IAIABC, Medicaid agencies, Medicare, and NCPDP are being considered for inclusion in the defined representative voting panel. Before the ECO finalizes the list, the Subcommittee is seeking feedback about other industry groups or organizations with a material interest in the code lists CMG04 will maintain.

Suggestions regarding other groups with a material interest in the CMG04 code lists were submitted prior to Monday, June 1, 2020.

For more information about code maintenance groups in general or X12's external code lists, submit your request via X12's online feedback form, selecting the "RSC|ECO" category.

Thank you for your interest in X12's external code lists. Watch for more opportunities to participate in the development and maintenance of code lists in the coming months.