Code	Error Short Description	Details
CB01	Detail or Auxiliary Record Identifier	"Required. Must be equal to ""NGCD"" (Claim Input File Detail Record) or ""NGCE"" (Claim Input File Auxiliary Record). ""NGCE"" must always follow an ""NGCD"" record. If ""NGCE"" record submitted, DCN/HICN/SSN/Injured Party First Name/Injured Party Last Name must match values on the ""NGCD"" record."
CB02	DCN	Required. Field must contain value greater than spaces. Value on each detail record must be unique within the file submission.
CB03	Action Type	"Required. Field must contain a numeric character. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record, 1 = Delete Record, 2 = Update Record."
CB04	Injured Party HICN	Field must contain spaces or alphanumeric characters. No dashes or hyphens allowed.  
CB05	Injured Party SSN	"Field must contain all spaces or a numeric value. No dashes, hyphens or special characters allowed.  "
CB06	Injured Party HICN/SSN	A valid Injured Party HICN or Injured Party SSN must be provided. 
CB07	Injured Party Last Name	"Required. First position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space. Submit as shown on Social Security or Medicare Card."
CB08	Injured Party First Name	Required. Must contain letters or spaces. Submit as shown on Social Security or Medicare Card. 
CB09	Injured Party Middle Init	Optional. Field must contain an alphabetic character or space.  No other characters allowed.
CB10	Injured Party Gender	"Required.  Field must contain a numeric character.  Field cannot be spaces or alpha characters.  Acceptable numeric characters include the following: 0 = Unknown, 1 = Male, 2 = Female."
CB11	Injured Party DOB	"Required. Field must be numeric and contain a valid date prior to the current date. Formatted as CCYYMMDD. Field cannot contain spaces, alpha characters or all zeroes."
CC01	Claimant  1 Relationship	"Must be an alpha value of: E = Estate, Individual Name, F = Family, Individual Name, O = Other, Individual Name, X = Estate, Entity Name, Y = Family, Entity Name, Z = Other, Entity Name, Space = Not Applicable."
CC02	Claimant 1 TIN	"If Claimant 1 Relationship is not equal to spaces, field must contain a non-zero 9-digit numeric value. May contain a 9-digit number, all zeroes or all spaces. Must not match other Claimant TINs.  "
CC03	Claimant 1 Last Name	"If Claimant 1 Relationship equal to space, field must be equal to spaces. If Claimant 1 Relationship = ""E"", ""F"" or ""O"", first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CC04	Claimant 1 First Name	"If Claimant 1 Relationship equal to space, field must be equal to spaces. . If Claimant 1 Relationship = ""E"", ""F"" or ""O"", first position must be an alphabetic character. Other positions must contain letters or spaces."
CC05	Claimant 1 Middle Initial	"Field must be equal to space or an alpha character. If Claimant 1 Relationship equal to space, field must be equal to space.   "
CC06	Claimant 1 Mailing Address Line 1	"Required if Claimant 1 Relationship is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Claimant 1 Relationship is equal to spaces, field must be equal to spaces. If Claimant 1 State = ""FC"", field must be equal to all spaces"
CC07	Claimant 1 Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CC08	Claimant 1 City	"Required if Claimant 1 Relationship is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Claimant 1 Relationship is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If Claimant 1 State = ""FC"", field must be equal to all spaces"
CC09	Claimant 1 State	"If Claimant 1 Relationship is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If Claimant 1 Relationship equal to spaces, field must be equal to spaces."
CC10	Claimant 1 Zip	"If Claimant 1 Relationship is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If Claimant 1 Relationship equal to spaces, field must be equal to zeroes. If Claimant 1 State = ""FC"", field must be equal to all zeroes."
CC11	Claimant 1 Zip+4	"If Claimant 1 Relationship is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes. If Claimant 1 Relationship equal to spaces, field must be equal to zeroes. If Claimant 1 State = ""FC"", field must be equal to all zeroes."
CC12	Claimant 1 Phone	"If Claimant 1 Relationship is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If Claimant 1 Relationship equal to spaces, field must be equal to zeroes. If Claimant 1 State = ""FC"", field must be equal to all zeroes."
CC13	Claimant 1 Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If Claimant 1 Relationship equal to spaces, field must be equal to spaces."
CC14	Claimant 1 Entity/Organization Name	"If Claimant 1 Relationship equal to space, field must contain spaces. If Claimant 1 Relationship = ""X"", ""Y"", or ""Z"", field must contain alpha and/or numeric characters, spaces, commas, & - ' . @ # / : ; . and field must contain at least 2 non-space alphanumeric characters."
CC21	Claimant 2 Relationship	"Must be an alpha value of: E = Estate, Individual Name,  F = Family, Individual Name, O = Other, Individual Name, X = Estate, Entity Name, Y = Family, Entity Name, Z = Other, Entity Name, Space = Not Applicable."
CC22	Claimant 2 TIN	"If Claimant 2 Relationship is not equal to spaces, field must contain a non-zero 9-digit numeric value. May contain a 9-digit number, all zeroes or all spaces. Must not match other Claimant SSNs.  "
CC23	Claimant 2 Last Name	"If Claimant 2 Relationship equal to space, field must be equal to spaces. If Claimant 2 Relationship = ""E"", ""F"" or ""O"", first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CC24	Claimant 2 First Name	"If Claimant 2 Relationship equal to space, field must be equal to spaces. . If Claimant 2 Relationship = ""E"", ""F"" or ""O"", first position must be an alphabetic character. Other positions must contain letters or spaces."
CC25	Claimant 2 Middle Initial	"Field must be equal to space or an alpha character. If Claimant 2 Relationship equal to space, field must be equal to space.  "
CC26	Claimant 2 Mailing Address Line 1	"Required if Claimant 2 Relationship is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Claimant 2 Relationship is equal to spaces, field must be equal to spaces. If Claimant 2 State = ""FC"", field must be equal to all spaces"
CC27	Claimant 2 Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CC28	Claimant 2 City	"Required if Claimant 2 Relationship is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Claimant 2 Relationship is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If Claimant 2 State = ""FC"", field must be equal to all spaces"
CC29	Claimant 2 State	"If Claimant 2 Relationship is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If Claimant 2 Relationship equal to spaces, field must be equal to spaces."
CC30	Claimant 2 Zip	"If Claimant 2 Relationship is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If Claimant 2 Relationship equal to spaces, field must be equal to zeroes. If Claimant 2 State = ""FC"", field must be equal to all zeroes."
CC31	Claimant 2 Zip+4	"If Claimant 2 Relationship is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes. If Claimant 2 Relationship equal to spaces, field must be equal to zeroes. If Claimant 2 State = ""FC"", field must be equal to all zeroes."
CC32	Claimant 2 Phone	"If Claimant 2 Relationship is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If Claimant 2 Relationship equal to spaces, field must be equal to zeroes. If Claimant 2 State = ""FC"", field must be equal to all zeroes."
CC33	Claimant 2 Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If Claimant 2 Relationship equal to spaces, field must be equal to spaces."
CC34	Claimant 2 Entity/Organization Name	"If Claimant 2 Relationship equal to space, field must contain spaces. If Claimant 2 Relationship = ""X"", ""Y"", or ""Z"", field must contain alpha and/or numeric characters, spaces, commas, & - ' . @ # / : ; . and field must contain at least 2 non-space alphanumeric characters."
CC41	Claimant 3 Relationship	"Must be an alpha value of: E = Estate, Individual Name, F = Family, Individual Name, O = Other, Individual Name, X = Estate, Entity Name, Y = Family, Entity Name, Z = Other, Entity Name, Space = Not Applicable."
CC42	Claimant 3 TIN	"If Claimant 3 Relationship is not equal to spaces, field must contain a non-zero 9-digit numeric value. May contain a 9-digit number, all zeroes or all spaces. Must not match other Claimant TINs."
CC43	Claimant 3 Last Name	"If Claimant 3 Relationship equal to space, field must be equal to spaces. If Claimant 3 Relationship = ""E"", ""F"" or ""O"", first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CC44	Claimant 3 First Name	"If Claimant 3 Relationship equal to space, field must be equal to spaces. . If Claimant 3 Relationship = ""E"", ""F"" or ""O"", first position must be an alphabetic character. Other positions must contain letters or spaces."
CC45	Claimant 3 Middle Initial	"Field must be equal to space or an alpha character. f Claimant 3 Relationship equal to space, field must be equal to space.   "
CC46	Claimant 3 Mailing Address Line 1	"Required if Claimant 3 Relationship is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Claimant 3 Relationship is equal to spaces, field must be equal to spaces. If Claimant 3 State = ""FC"", field must be equal to all spaces"
CC47	Claimant 3 Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CC48	Claimant 3 City	"Required if Claimant 3 Relationship is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Claimant 3 Relationship is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If Claimant 3 State = ""FC"", field must be equal to all spaces"
CC49	Claimant 3 State	"If Claimant 3 Relationship is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If Claimant 3 Relationship equal to spaces, field must be equal to spaces."
CC50	Claimant 3 Zip	"If Claimant 3 Relationship is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If Claimant 3 Relationship equal to spaces, field must be equal to zeroes. If Claimant 3 State = ""FC"", field must be equal to all zeroes."
CC51	Claimant 3 Zip+4	"If Claimant 3 Relationship is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes. If Claimant 3 Relationship equal to spaces, field must be equal to zeroes. If Claimant 3 State = ""FC"", field must be equal to all zeroes."
CC52	Claimant 3 Phone	"If Claimant 3 Relationship is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If Claimant 3 Relationship equal to spaces, field must be equal to zeroes. If Claimant 3 State = ""FC"", field must be equal to all zeroes."
CC53	Claimant 3 Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If Claimant 3 Relationship equal to spaces, field must be equal to spaces."
CC54	Claimant 3 Entity/Organization Name	"If Claimant 3 Relationship equal to space, field must contain spaces. If Claimant 3 Relationship = ""X"", ""Y"", or ""Z"", field must contain alpha and/or numeric characters, spaces, commas, & - ' . @ # / : ; . and field must contain at least 2 non-space alphanumeric characters."
CC61	Claimant 4 Relationship	"Must be an alpha value of: E = Estate, Individual Name, F = Family, Individual Name, O = Other, Individual Name, X = Estate, Entity Name, Y = Family, Entity Name, Z = Other, Entity Name, Space = Not Applicable."
CC62	Claimant 4 TIN	"If Claimant 4 Relationship is not equal to spaces, field must contain a non-zero 9-digit numeric value. May contain a 9-digit number, all zeroes or all spaces. Must not match other Claimant TINs."
CC63	Claimant 4 Last Name	"If Claimant 4 Relationship equal to space, field must be equal to spaces. If Claimant 4 Relationship = ""E"", ""F"" or ""O"", first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CC64	Claimant 4 First Name	"If Claimant 4 Relationship equal to space, field must be equal to spaces. . If Claimant 4 Relationship = ""E"", ""F"" or ""O"", first position must be an alphabetic character. Other positions must contain letters or spaces."
CC65	Claimant 4 Middle Initial	"Field must be equal to space or an alpha character. If Claimant 4 Relationship equal to space, field must be equal to space.   "
CC66	Claimant 4 Mailing Address Line 1	"Required if Claimant 4 Relationship is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Claimant 4 Relationship is equal to spaces, field must be equal to spaces. If Claimant 4 State = ""FC"", field must be equal to all spaces"
CC67	Claimant 4 Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CC68	Claimant 4 City	"Required if Claimant 4 Relationship is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Claimant 4 Relationship is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If Claimant 4 State = ""FC"", field must be equal to all spaces"
CC69	Claimant 4 State	"If Claimant 4 Relationship is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If Claimant 4 Relationship equal to spaces, field must be equal to spaces."
CC70	Claimant 4 Zip	"If Claimant 4 Relationship is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If Claimant 4 Relationship equal to spaces, field must be equal to zeroes. If Claimant 4 State = ""FC"", field must be equal to all zeroes."
CC71	Claimant 4 Zip+4	"If Claimant 4 Relationship is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes. If Claimant 4 Relationship equal to spaces, field must be equal to zeroes. If Claimant 4 State = ""FC"", field must be equal to all zeroes."
CC72	Claimant 4 Phone	"If Claimant 4 Relationship is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If Claimant 4 Relationship equal to spaces, field must be equal to zeroes. If Claimant 4 State = ""FC"", field must be equal to all zeroes."
CC73	Claimant 4 Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If Claimant 4 Relationship equal to spaces, field must be equal to spaces."
CC74	Claimant 4 Entity/Organization Name	"If Claimant 4 Relationship equal to space, field must contain spaces. If Claimant 4 Relationship = ""X"", ""Y"", or ""Z"", field must contain alpha and/or numeric characters, spaces, commas, & - "" . @ # / : ; . and field must contain at least 2 non-space alphanumeric characters."
CI01	CMS Date of Incident	"Required. Field must be numeric and a valid date prior to or equal to the current date. Formatted as CCYYMMDD. Field cannot contain spaces, alpha characters or all zeroes. "
CI02	Industry Date of Incident	Optional. Edit bypassed if field equal to all zeroes. Field must be numeric and contain a valid date prior to or equal to the current date or equal to zeroes. Formatted as CCYYMMDD.
CI03	Alleged Cause of Injury	"Required for Add and Update records (Action Type = 0 or 2) as of 01/01/2011. If field is equal to spaces prior to 01/01/2011 edit bypassed. First position must be ""E"". Field must contain a valid ICD-9-CM ""E"" Code after 1/1/2011. May equal to spaces prior to 1/1/2011. Must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not include decimal point.   "
CI04	State of Venue	"Required. Must be a valid US Postal state abbreviation (www.usps.com/ncsc/lookups/abbreviations.html), a value of ""US"", or a value of ""FC""."
CI05	ICD-9 Diagnosis Code 1	"Required for Add and Update records (Action Type = 0 or 2) as of 01/01/2011. May equal spaces prior to 1/1/2011. If field is equal to spaces prior to 01/01/2011 edit bypassed. Must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point. "
CI06	ICD-9 Diagnosis Code 2	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI07	ICD-9 Diagnosis Code 3	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI08	ICD-9 Diagnosis Code 4	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI09	ICD-9 Diagnosis Code 5	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI10	ICD-9 Diagnosis Code 6	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI11	ICD-9 Diagnosis Code 7	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI12	ICD-9 Diagnosis Code 8	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI13	ICD-9 Diagnosis Code 9	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI14	ICD-9 Diagnosis Code 10	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI15	ICD-9 Diagnosis Code 11	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI16	ICD-9 Diagnosis Code 12	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI17	ICD-9 Diagnosis Code 13	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI18	ICD-9 Diagnosis Code 14	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI19	ICD-9 Diagnosis Code 15	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI20	ICD-9 Diagnosis Code 16	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI21	ICD-9 Diagnosis Code 17	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI22	ICD-9 Diagnosis Code 18	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI23	ICD-9 Diagnosis Code 19	"Optional. Must contain spaces or must match a value in the first 5 bytes of a record on one of the 3 most current lists of valid ICD-9 diagnosis codes at www.cms.gov/ICD9ProviderDiagnosticCodes/06_codes.asp. Must not be on the list of ?Excluded Codes? in Appendix H. Must not begin with ""E"". Must not begin with ""V"". Must not include decimal point."
CI24	Description of Illness/Injury	Required on Add and Update records (Action Type = 0 or 2) if ICD-9-CM Diagnosis Code 1 and Alleged Cause of Injury not both provided and prior to 01/01/2011. If required must contain alphanumeric characters and not equal to spaces.  
CI25	ICD-9 Diagnosis and Alleged Cause of Injury	"Prior to 01/01/2011, at least a valid ICD-9 Diagnosis Code 1 and a valid Alleged Cause of Injury must be provided or Description of Illness/Injury must be provided. After 12/31/2010, both a valid ICD-9 Diagnosis Code 1 and a valid Alleged Cause of Injury must be provided."
CI26	Product Liability Indicator	Not used.
CI27	Product Generic Name	Not used. 
CI28	Product Brand Name	Not used. 
CI29	Product Manufacturer	Not used.
CI30	Product Alleged Harm	Not used. 
CI31	ICD indicator	"Required.  Must be one of the following values: ""0"" ? ICD-10-CM diagnosis codes, ""9"" ? ICD-9-CM diagnosis codes, Space ? ICD-9-CM diagnosis codes. Claims submitted with a CMS DOI on or after April 1, 2015 that contain an ICD indicator of ""9"" or space will also be rejected with a CI31 error. "
CJ01	ORM Indicator	"Required. Must contain a value of ""Y"" or ""N""."
CJ02	ORM Termination Date	"Must contain a valid date or zeroes.  Must be all zeroes if ORM Indicator = ""N"". Future dates are allowed. "
CJ03	TPOC Date 1	Must contain a valid date or zeroes. Date must be equal to or prior to current date (COBC processing date). Required if a non-zero TPOC Amount 1 is supplied. Must be greater than the CMS Date of Incident (Field 12 of the Claim Input File Detail Record). Must be zero if TPOC Amount 1 is zero.  
CJ04	TPOC Amount 1	Must contain a numeric value or zeroes. Required if a non-zero TPOC Date 1 is supplied. Must be zero if TPOC Date 1 is zero. 
CJ05	Funding Delayed Beyond TPOC Start Date 1	Must contain a valid date or zeroes. 
CJ06	DOI/ORM Termination Date	ORM Termination Date must be at least 30 days after the CMS Date of Incident. Cannot be more than 6 months greater than the file submission date.  
CJ07	TPOC Threshold	"Total of TPOC Amounts reported on Add record (Action Type = 0) with ORM Indicator = ""N"" does not exceed interim reporting threshold.  "
CP01	Plan Insurance Type	"Required. Must contain one of the following alpha characters: ""D"" = No-Fault, ""E"" = Workers"" Compensation, ""L"" = Liability."
CP02	TIN	Required. Must contain a valid 9-digit IRS-assigned Federal Tax Identification Number or foreign RRE pseudo-TIN. A corresponding TIN record must have been submitted on the TIN Reference File. Must be numeric. Include leading zeroes. Do not include hyphens.  
CP03	Office Code/Site ID	Optional. Must be equal to spaces or must contain a 9-digit numeric code. Must have a corresponding entry with associated TIN on the TIN Reference File. A record must be submitted on the TIN Reference File for each unique TIN/Office Code combination.
CP04	Policy Number	"Required. Must be at least 3 characters in length. Acceptable characters (alpha, numeric, space, comma, & - ' . @ # / ; or :).  Cannot be equal to all spaces."
CP05	Claim Number	Required. Must contain alphanumeric values and cannot be equal to spaces.
CP06	Plan Contact Department Name	"Optional. Field may contain alphanumeric characters.  If field is not used, field must contain spaces.  "
CP07	Plan Contact Last Name	"Optional. If greater than spaces, first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CP08	Plan Contact First Name	"Optional. If greater than spaces, first position must be an alphabetic character. Other positions must contain letters or spaces."
CP09	Plan Contact Phone	Optional. Must contain 10-digit numeric value or zeroes if not provided. 
CP10	Plan Contact Phone Extension	Optional. Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. 
CP11	No-Fault Insurance Limit	"Must contain a numeric value or all zeroes. If Plan Insurance Type is equal to ""D"", a value greater than zeroes must be provided. Fill with all 9""s if there is no dollar limit. Fill with zeroes if Plan Insurance Type is ""E"" or ""L"". "
CP12	Exhaust Date for No-Fault Insurance Limit	"Must contain zeroes or a valid date. If Plan Insurance Type is equal to an ""E"" or ""L"", must contain zeroes. "
CP13	TIN/Office Code Mailing Name	"Required. Field must contain at least 2 alphanumeric characters.  If the Insurer""s plan name is equal to SUPPLEMENT, SUPPLEMENTAL, INSURER, MISCELLANEOUS, CMS, ATTORNEY, UNKNOWN, NONE, N/A, UN, MISC, NO, BC, BX, BS, BCBX, BLUE CROSS, BLUE SHIELD, or MEDICARE the CP13 error will be applied. Extracted from TIN Reference file. "
CP14	TIN/Office Code Mailing Address Line 1	"Required. Field must contain alphanumeric characters. Field cannot be blank or equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If TIN/Office Code State is ""FC"", must be blank. Extracted from TIN Reference file."
CP15	TIN/Office Code Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .   If TIN/Office Code State is ""FC"", must be blank. Extracted from TIN Reference file."
CP16	TIN/Office Code City	"Required. Embedded spaces are allowed for multi-word city name. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; . If TIN/Office Code State is ""FC"", must be blank. Extracted from TIN Reference file."
CP17	TIN/Office Code State	"Required. Field must contain US Postal Abbreviation Code or ""FC"". See www.usps.com/ncsc/lookups/abbreviations.html. Extracted from TIN Reference file."
CP18	TIN/Office Code Zip	"Required. Field must contain a valid 5-digit numeric US Zip Code. If TIN/Office Code State is ""FC"", must be blank. Extracted from TIN Reference file."
CP19	TIN/Office Code Zip+4	"Field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes. If TIN/Office Code State is ""FC"", must be zeroes. Extracted from TIN Reference file."
CP20	Foreign RRE Address Line 1	"If TIN/Office Code State is not ""FC"", must be equal to spaces. If TIN/Office Code State is ""FC"", must contain at least one non-blank character.  "
CP21	Foreign RRE Address Line 2	"If TIN/Office Code State is not ""FC"", must be equal to spaces. If TIN/Office Code State is ""FC"", must be blank or valid alphanumeric characters."
CP22	Foreign RRE Address Line 3	"If TIN/Office Code State is not ""FC"", must be equal to spaces. If TIN/Office Code State is ""FC"", must be blank or valid alphanumeric characters."
CP23	Foreign RRE Address Line 4	"If TIN/Office Code State is not ""FC"", must be equal to spaces. If TIN/Office Code State is ""FC"", must be blank or valid alphanumeric characters."
CR01	Injured Party Representative Indicator	"Must be an alpha value of: ""A"" = Attorney, ""G"" = Guardian, ""P"" = Power of Attorney, ""O"" = Other, Space = None."
CR02	Representative Last Name	"If Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CR03	Representative First Name	"If Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions must contain letters or spaces."
CR04	Representative Firm Name	"If Representative Indicator equal to space, field must contain spaces. Field may contain alpha and/or numeric characters, spaces, commas, & - ' . @ # / : ; . If supplied, must contain at least 2 alphanumeric characters."
CR05	Representative TIN	"May contain a 9-digit number, all zeroes or all spaces. "
CR06	Representative Mailing Address Line 1	"Required if Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Representative Indicator is equal to spaces, field must be equal to spaces. If Representative State = ""FC"", field must be equal to all spaces. "
CR07	Representative Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CR08	Representative City	"Required if Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If Representative Indicator is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If Representative State = ""FC"", field must be equal to all spaces "
CR09	Representative State	"If Representative Indicator is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If Representative Indicator equal to spaces, field must be equal to spaces. "
CR10	Representative Mail Zip Code	"If Representative Indicator is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If Representative Indicator equal to spaces, field must be equal to zeroes. If Representative State = ""FC"", field must be equal to all zeroes."
CR11	Representative Mail Zip+4	"If Representative Indicator is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes If Representative Indicator equal to spaces, field must be equal to zeroes. If Representative State = ""FC"", field must be equal to all zeroes."
CR12	Representative Phone	"If Representative Indicator is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If Representative Indicator equal to spaces, field must be equal to zeroes. If Representative State = ""FC"", field must be equal to all zeroes."
CR13	Representative Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If Representative Indicator equal to spaces, field must be equal to spaces."
CR14	Representative Name/Firm Name	"Either Representative Last Name and Representative First Name ? or ? Representative Firm Name is required, if Representative Indicator is not equal to spaces."
CR21	Claimant 1 Representative Indicator	"Must be an alpha value of: ""A"" = Attorney, ""G"" = Guardian, ""P"" = Power of Attorney, ""O"" = Other, Space = None."
CR22	Claimant 1 Representative Last Name	"If C1 Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CR23	Claimant 1 Representative First Name	"If C1 Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions must contain letters or spaces."
CR24	Claimant 1 Representative Firm Name	"If C1 Representative Indicator equal to space, field must contain spaces. Field may contain alpha and/or numeric characters, spaces, commas, & - ' . @ # / : ; . If supplied, must contain at least 2 alphanumeric characters."
CR25	Claimant 1 Representative TIN	"May contain a 9-digit number, all zeroes or all spaces."
CR26	Claimant 1 Representative Mailing Address 1	"Required if C1 Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If C1 Representative Indicator is equal to spaces, field must be equal to spaces. If C1 Representative State = ""FC"", field must be equal to all spaces. "
CR27	Claimant 1 Representative Mailing Address 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CR28	Claimant 1 Representative Mailing City	"Required if C1 Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If C1 Representative Indicator is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If C1 Representative State = ""FC"", field must be equal to all spaces "
CR29	Claimant 1 Representative State	"If C1 Representative Indicator is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If C1 Representative Indicator equal to spaces, field must be equal to spaces. "
CR30	Claimant 1 Representative Zip	"If C1 Representative Indicator is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If C1 Representative Indicator equal to spaces, field must be equal to zeroes. If C1 Representative State = ""FC"", field must be equal to all zeroes."
CR31	Claimant 1 Representative Zip+4	"If C1 Representative Indicator is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes If C1 Representative Indicator equal to spaces, field must be equal to zeroes. If C1 Representative State = ""FC"", field must be equal to all zeroes."
CR32	Claimant 1 Representative Phone	"If C1 Representative Indicator is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If C1 Representative Indicator equal to spaces, field must be equal to zeroes. If C1 Representative State = ""FC"", field must be equal to all zeroes."
CR33	Claimant 1 Representative Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If C1 Representative Indicator equal to spaces, field must be equal to spaces."
CR34	Claimant 1 Representative Name/Firm Name	Either C1 Representative Last Name and C1 Representative First Name ? or ? C1 Representative Firm Name is required if C1 Representative Indicator is not equal to spaces.
CR41	Claimant 2 Representative Indicator	"Must be an alpha value of: ""A"" = Attorney, ""G"" = Guardian, ""P"" = Power of Attorney, ""O"" = Other, Space = None."
CR42	Claimant 2 Representative Last Name	"If C2 Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CR43	Claimant 2 Representative First Name	"If C2 Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions must contain letters or spaces."
CR44	Claimant 2 Representative Firm Name	"If C2 Representative Indicator equal to space, field must contain spaces. Field may contain alpha and/or numeric characters, spaces, commas, & - ' . @ # / : ; . If supplied, must contain at least 2 alphanumeric characters."
CR45	Claimant 2 Representative TIN	"May contain a 9-digit number, all zeroes or all spaces."
CR46	Claimant 2 Representative Mailing Address Line 1	"Required if C2 Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If C2 Representative Indicator is equal to spaces, field must be equal to spaces. If C2 Representative State = ""FC"", field must be equal to all spaces. "
CR47	Claimant 2 Representative Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CR48	Claimant 2 Representative City	"Required if C2 Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If C2 Representative Indicator is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If C2 Representative State = ""FC"", field must be equal to all spaces "
CR49	Claimant 2 Representative State	"If C2 Representative Indicator is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If C2 Representative Indicator equal to spaces, field must be equal to spaces. "
CR50	Claimant 2 Representative Zip	"If C2 Representative Indicator is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If C2 Representative Indicator equal to spaces, field must be equal to zeroes. If C2 Representative State = ""FC"", field must be equal to all zeroes."
CR51	Claimant 2 Representative Zip+4	"If C2 Representative Indicator is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes If C2 Representative Indicator equal to spaces, field must be equal to zeroes. If C2 Representative State = ""FC"", field must be equal to all zeroes."
CR52	Claimant 2 Representative Phone	"If C2 Representative Indicator is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If C2 Representative Indicator equal to spaces, field must be equal to zeroes. If C2 Representative State = ""FC"", field must be equal to all zeroes."
CR53	Claimant 2 Representative Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If C2 Representative Indicator equal to spaces, field must be equal to spaces."
CR54	Claimant 2 Representative Name/Firm Name	Either C2 Representative Last Name and C2 Representative First Name ? or ? C2 Representative Firm Name is required if C2 Representative Indicator is not equal to spaces.
CR61	Claimant 3 Representative Indicator	"Must be an alpha value of: ""A"" = Attorney, ""G"" = Guardian, ""P"" = Power of Attorney, ""O"" = Other, Space = None."
CR62	Claimant 3 Representative Last Name	"If C3 Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CR63	Claimant 3 Representative First Name	"If C3 Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions must contain letters or spaces."
CR64	Claimant 3 Representative Firm Name	"If C3 Representative Indicator equal to space, field must contain spaces. Field may contain alpha and/or numeric characters, spaces, commas, & - ' . @ # / : ; .  If supplied, must contain at least 2 alphanumeric characters."
CR65	Claimant 3 Representative TIN	"May contain a 9-digit number, all zeroes or all spaces."
CR66	Claimant 3 Representative Mailing Address Line 1	"Required if C3 Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If C3 Representative Indicator is equal to spaces, field must be equal to spaces. If C3 Representative State = ""FC"", field must be equal to all spaces. "
CR67	Claimant 3 Representative Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CR68	Claimant 3 Representative City	"Required if C3 Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If C3 Representative Indicator is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If C3 Representative State = ""FC"", field must be equal to all spaces "
CR69	Claimant 3 Representative State	"If C3 Representative Indicator is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If C3 Representative Indicator equal to spaces, field must be equal to spaces. "
CR70	Claimant 3 Representative Zip	"If C3 Representative Indicator is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If C3 Representative Indicator equal to spaces, field must be equal to zeroes. If C3 Representative State = ""FC"", field must be equal to all zeroes."
CR71	Claimant 3 Representative Zip+4	"If C3 Representative Indicator is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes If C3 Representative Indicator equal to spaces, field must be equal to zeroes. If C3 Representative State = ""FC"", field must be equal to all zeroes."
CR72	Claimant 3 Representative Phone	"If C3 Representative Indicator is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If C3 Representative Indicator equal to spaces, field must be equal to zeroes. If C3 Representative State = ""FC"", field must be equal to all zeroes."
CR73	Claimant 3 Representative Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If C3 Representative Indicator equal to spaces, field must be equal to spaces."
CR74	Claimant 3 Representative Name/Firm Name	Either C3 Representative Last Name and C3 Representative First Name ? or ? C3 Representative Firm Name is required if C3 Representative Indicator is not equal to spaces.
CR81	Claimant 4 Representative Indicator	"Must be an alpha value of: ""A"" = Attorney, ""G"" = Guardian, ""P"" = Power of Attorney, ""O"" = Other, Space = None."
CR82	Claimant 4 Representative Last Name	"If C4 Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space."
CR83	Claimant 4 Representative First Name	"If C4 Representative Indicator equal to space, field must be equal to spaces. If greater than spaces, first position must be an alphabetic character. Other positions must contain letters or spaces."
CR84	Claimant 4 Representative Firm Name	"If C4 Representative Indicator equal to space, field must contain spaces. Field may contain alpha and/or numeric characters, spaces, commas, & - ' . @ # / : ; . If supplied, must contain at least 2 alphanumeric characters."
CR85	Claimant 4 Representative TIN	"May contain a 9-digit number, all zeroes or all spaces."
CR86	Claimant 4 Representative Mailing Address Line 1	"Required if C4 Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If C4 Representative Indicator is equal to spaces, field must be equal to spaces. If C4 Representative State = ""FC"", field must be equal to all spaces. "
CR87	Claimant 4 Representative Mailing Address Line 2	"Optional. If field greater than spaces, field must contain at least 2 alphanumeric characters."
CR88	Claimant 4 Representative City	"Required if C4 Representative Indicator is not equal to space. If required, cannot be equal to all spaces. Field may contain alpha and/or numeric characters plus the following special characters commas, & - ' . @ # / : ; .  If C4 Representative Indicator is equal to spaces, field must be equal to spaces. Embedded spaces are allowed for multi-word city name. If C4 Representative State = ""FC"", field must be equal to all spaces "
CR89	Claimant 4 Representative State	"If C4 Representative Indicator is not equal to spaces, field must contain US Postal Abbreviation Code or ""FC"".  If C4 Representative Indicator equal to spaces, field must be equal to spaces. "
CR90	Claimant 4 Representative Zip	"If C4 Representative Indicator is not equal to spaces, field must contain a valid 5-digit numeric US Zip Code.  If C4 Representative Indicator equal to spaces, field must be equal to zeroes. If C4 Representative State = ""FC"", field must be equal to all zeroes."
CR91	Claimant 4 Representative Zip+4	"If C4 Representative Indicator is not equal to spaces, field must contain a valid 4-digit numeric US Zip+4 Code or all zeroes If C4 Representative Indicator equal to spaces, field must be equal to zeroes. If C4 Representative State = ""FC"", field must be equal to all zeroes."
CR92	Claimant 4 Representative Phone	"If C4 Representative Indicator is not equal to spaces, field must contain a non-zero 10-digit numeric value.  If C4 Representative Indicator equal to spaces, field must be equal to zeroes. If C4 Representative State = ""FC"", field must be equal to all zeroes."
CR93	Claimant 4 Representative Phone Extension	"Phone extensions must be left-justified and unused bytes filled with spaces. Must contain all spaces if not provided. If C4 Representative Indicator equal to spaces, field must be equal to spaces."
CR94	Claimant 4 Representative Name/Firm Name	Either C4 Representative Last Name and C4 Representative First Name ? or ? C4 Representative Firm Name is required if C4 Representative Indicator is not equal to spaces.
CS01	Self Insured Indicator	"Required if Plan Insurance Type equal to ""E"" or ""L"". If required, value must be equal to ""Y"" or ""N"". If not required (Plan Insurance Type equals ""D"") must equal space or ""N"".  "
CS02	Self Insured Type	"Required if Self Insured Indicator equal to ""Y"". If required, value must equal to """"I or ""O"".  If not required must equal space."
CS03	Policyholder Last Name	"Required when Self Insured Type equal to ""I"". If required, first position must be an alphabetic character. Other positions may contain a letter, hyphen, apostrophe or space. Field must be equal to spaces if Self Insured type not equal to ""I"".       "
CS04	Policyholder First Name	"Required when Self Insured Type equal to ""I"". If required must contain letters or spaces. Field must be equal to spaces if Self Insured Type is not equal to ""I""."
CS05	DBA Name	"Field must be equal to spaces if Self Insured Type is equal to ""I"". If greater than spaces, field must contain at least 2 alphanumeric characters. "
CS06	Legal Name	"Field must be equal to spaces if Self Insured Type is equal to ""I"". If greater than spaces, field must contain at least 2 alphanumeric characters."
CS07	DBA/Legal Name	"DBA or Legal name must be provided if Self Insured Type is equal to ""O""."
CT01	TPOC Date 2	Must contain a valid date or zeroes. Date must be equal to or prior to current date (COBC processing date). Required if a non-zero TPOC Amount 2 is supplied. Must be greater than the CMS Date of Incident (Field 12 of the Claim Input File Detail Record). Must be zero if TPOC Amount 2 is zero.   
CT02	TPOC Amount 2	Must contain a numeric value or zeroes. Required if a non-zero TPOC Date 2 is supplied. Must be zero if TPOC Date 2 is zero.
CT03	Funding Delayed Beyond TPOC Start Date 2	Must contain a valid date or zeroes. 
CT11	TPOC Date 3	Must contain a valid date or zeroes. Date must be equal to or prior to current date (COBC processing date). Required if a non-zero TPOC Amount 3 is supplied. Must be greater than the CMS Date of Incident (Field 12 of the Claim Input File Detail Record). Must be zero if TPOC Amount 3 is zero.   
CT12	TPOC Amount 3	Must contain a numeric value or zeroes. Required if a non-zero TPOC Date 3 is supplied. Must be zero if TPOC Date 3 is zero.
CT13	Funding Delayed Beyond TPOC Start Date 3	Must contain a valid date or zeroes. 
CT21	TPOC Date 4	Must contain a valid date or zeroes. Date must be equal to or prior to current date (COBC processing date). Required if a non-zero TPOC Amount 4 is supplied. Must be greater than the CMS Date of Incident (Field 12 of the Claim Input File Detail Record). Must be zero if TPOC Amount 4 is zero.
CT22	TPOC Amount 4	Must contain a numeric value or zeroes. Required if a non-zero TPOC Date 4 is supplied. Must be zero if TPOC Date 4 is zero.
CT23	Funding Delayed Beyond TPOC Start Date 4	Must contain a valid date or zeroes. 
CT31	TPOC Date 5	Must contain a valid date or zeroes. Date must be equal to or prior to current date (COBC processing date). Required if a non-zero TPOC Amount 5 is supplied. Must be greater than the CMS Date of Incident (Field 12 of the Claim Input File Detail Record).  Must be zero if TPOC Amount 5 is zero.  
CT32	TPOC Amount 5	Must contain a numeric value or zeroes. Required if a non-zero TPOC Date 5 is supplied. Must be zero if TPOC Date 5 is zero.
CT33	Funding Delayed Beyond TPOC Start Date 5	Must contain a valid date or zeroes. 
SP31	Action Type	Record submitted prior to effective date of Medicare entitlement. Injured Party matched to a Medicare beneficiary. No correction necessary by RRE. Resubmit record in next quarterly file submission. 
SP47	Action Type	No previously accepted record can be matched to submitted delete. Delete failed.
SP48	Action Type	No previously accepted record can be matched to submitted delete. Delete failed.
SP49	Action Type	No previously accepted record can be matched to submitted delete. Delete failed. 
SP50	Action Type	Transaction attempted to add/update/delete an ORM record locked by the BCRC. No changes are accepted via Section 111 reporting. Do NOT attempt to resubmit this record. See the NGHP User Guide Technical Information Chapter IV (Section 7.2).
TN01	Invalid RRE TIN	"TIN cannot be validated by the COBC. If RRE ID is associated with a foreign entity with no TIN, must be formatted as 9999xxxxx where ""xxxxx"" is an RRE-defined number. If you believe the TIN to be valid, contact your EDI Representative to supply supporting evidence. Your EDI Representative will update the system to mark the TIN as valid and then you may resend the record. Also known as the Employer Identification Number (EIN). Must be numeric. Include leading zeroes. Do not include hyphens.  "
TN02	Invalid Office Code/Site ID	Must be equal to spaces or must be a 9-digit numeric code.
TN03	Invalid TIN/Office Code Name 	"Cannot contain only the following word(s): SUPPLEMENTAL, SUPPLEMENT, INSURER, MISCELLANEOUS, CMS, ATTORNEY, UNKNOWN, NONE, N/A, UN, MISC, NA, NO, BC, BX, BS, BCBX, BLUE CROSS, BLUE SHIELD, or MEDICARE. Special characters other than , $ ? "" . @ # / : ; are not allowed. "
TN04	Invalid TIN/Office Code Mailing Address Line 1	"Must be a US address. Limit field to no more than eight separate words in the first 40 characters for best results. This address line should be used for the primary street address information including suite and/or apartment number if possible. If the RRE has registered as a foreign entity and no US address is available, fill with spaces and supply ""FC"" in the TIN/Office Code State (Field 9). If TIN/Office Code State (Field 9) = ""FC"", this field must be spaces."
TN05	Invalid TIN/Office Code Mailing Address Line 2	"Must be a US address. Limit field to no more than eight separate words in the first 40 characters for best results. This address line should be used for the secondary street address information such as ""ATTN TO"", internal mailstops, department name, etc. If the RRE has registered as a foreign entity and no US address is available, fill with spaces and supply ""FC"" in the TIN/Office Code State (Field 9). If TIN/Office Code State (Field 9) = ""FC"", this field must be spaces. If the RRE will be submitting TPA information via the TIN Reference File, submit the TPA's name in Field 7 prefaced by ""C/O"" or ""ATTN""."
TN06	Invalid TIN/Office Code City	"Must be a US city. Field may contain only alphabetic, Space, Comma, &?' . @ # / ; : characters. No numeric characters allowed. If the RRE has registered as a foreign entity and no US address is available, fill with spaces and supply ""FC"" in the TIN/Office Code State (Field 9). If TIN/Office Code State (Field 9) = ""FC"", this field must be spaces. If the RRE will be submitting TPA information via the TIN Reference File, submit the TPA's City."
TN07	Invalid TIN/Office Code State	"Must contain ""FC"" or a valid US postal state code."
TN08	Invalid TIN/Office Code Zip	"Must contain 5 numeric digits when Field 9 does not equal ""FC""; or must contain all zeros or all spaces when Field 9 = ""FC""."
TN09	Invalid TIN/Office Code Zip+4	"Must contain 4 numeric digits when Field 9 does not equal ""FC""; or must contain all zeros or all spaces when Field 9 = ""FC""."
TN10	N/A	Not used.
TN11	N/A	Not used.
TN12	N/A	Not used.
TN13	N/A	Not used.
TN14	N/A	Not used.
TN15	N/A	Not used.
TN16	N/A	Not used.
TN17	Foreign RRE Address Line 1-4 (Fields 12-15)	"Must be space-filled when Field 9 does not equal ""FC""; must be submitted when Field 9 = ""FC"". (Fields 12, 13, 14, 15)"
TN18	TIN Reference File Detail Record (Fields 6-11)	Address was insufficient to determine a match to the postal database.
TN19	TIN Reference File Detail Record (Fields 6-11)	Address matches an undeliverable address.
TN20	TIN Reference File Detail Record (Fields 6-11)	Apartment number was not found in the postal database or was not supplied for an address that requires an apartment number.
TN21	TIN Reference File Detail Record (Fields 6-11)	House or box number was not found on the street.
TN22	TIN Reference File Detail Record (Fields 6-11)	Street name not found in the postal database for the submitted ZIP code.
TN23	TIN Reference File Detail Record (Fields 6-11)	ZIP code not found in the postal database.
TN24	Recovery Agent Mailing Name (Field 16)	Must contain at least 2 characters. Must not contain special characters other than comma, period, ampersand, dash, @ # / semicolon, colon, single quote (‘).
TN25	Recovery Agent Mailing Address Line 1 (Field 17)	Required if Field 16 is used. If supplied, Field 16 must be entered. Must not contain special characters other than comma, period, ampersand, dash, @ # / semicolon, colon, single quote (‘).
TN26	Recovery Agent Mailing Address Line 2 (Field 18)	If supplied, Field 16 must be entered. Must not contain special characters other than comma, period, ampersand, dash, @ # / semicolon, colon, single quote (‘).
TN27	Recovery Agent City (Field 19)	Required if Field 16 is used. If supplied, Field 16 must be entered. Must not contain special characters other than comma, period, ampersand, dash, @ # / semicolon, colon, single quote (‘).
TN28	Recovery Agent State (Field 20)	Required if Field 16 is used. If supplied, Field 16 must be entered. Must contain a valid US postal state code.
TN29	Recovery Agent Zip (Field 21)	Required if Field 16 is used. If supplied, Field 16 must be entered. Must contain a valid US postal ZIP code.
TN30	Recovery Agent Zip+4 (Field 22)	If supplied, Field 16 must be entered. Must contain a valid US postal ZIP+4 code, all zeros (if not applicable), or all spaces.
TN31	Recovery Agent Address (Fields 16-22)	Address was insufficient to determine a match to the postal database.
TN32	Recovery Agent Address (Fields 16-22)	Address matches an undeliverable address.
TN33	Recovery Agent Address (Fields 17-18)	Apartment number was not found in the postal database or was not supplied for an address that requires an apartment number.
TN34	Recovery Agent Mailing Address (Field 17)	House or box number was not found on the street.
TN35	Recovery Agent Mailing Address (Field 17)	Street name not found in the postal database for the submitted ZIP code.
TN36	Recovery Agent Zip (Field 21)	ZIP code not found in the postal database.
TN99	TIN/Office Code (Fields 52-53)	No matching, valid TIN Reference File Detail Record was found for the TIN/Office Code combination on the Claim Input File Detail Record. Review errors returned on the TIN Reference Response File. Resubmit corrected TIN Reference File record and/or Claim Input File record.