IAIABC R1.0 STANDARDS: EDIT MATRIX USAGE INSTRUCTIONS
The Edit Matrix is designed to convey which data elements have edits applied to them and to
provide standard error messages to use in association with these edits. Error messages are
communicated in the Acknowledgment records in the Form of data element number and error
message. NOTE: All error messages and data element numbers must be assigned by the EDI
Systems group to ensure standardization across jurisdictions.
Those elements with ‘X’ on the coordinate are suggested or recommended edits. Trading
Partners should review these recommendations and may want to include/exclude edits, as they
feel appropriate, within the framework of the matrix.
The Edit Matrix includes all transaction set edits established by the IAIABC EDI Development
committee.
The data element numbers and element descriptions are listed down the left column while the
error message numbers and associated text are listed across the top of the table.
Some trading partners have found it useful to establish an additional table that contains more
specific, data element-related, and error messages. This can be useful, especially for error
messages that are more generic. Once they are tied to a data element, they can be made more
specific and reduce the need for follow-up phone calls from receivers.
Rev 02-15-02
© IAIABC 2011
1 of 1
© IAIABC 2011
IAIABC DATA ELEMENT NAME
Entire Transaction
Transaction Set ID
Maintenance Type Code
Maintenance Type Code Date
Jurisdiction
Agency Claim Number
Insurer FEIN
Insurer Name
Third Party Administrator FEIN
Third Party Administrator Name
Claim Administrator Addr Line 1
Claim Administrator Addr Line 2
Claim Administrator City
Claim Administrator State
Claim Administrator Postal Code
Claim Administrator Claim Number
Employer FEIN
Insured Name
Employer Name
Employer Address Line 1
Employer Address Line 2
Employer City
Employer State
Employer Postal Code
Self Insured Indicator
Industry Code
Insured Report Number
Insured Location Number
Policy Number
Policy Effective Date
Policy Expiration Date
Date of Injury
Time of Injury
Postal Code of Injury Site
Employers Premisis Indicator
Nature of Injury Code
Part of Body Injured Code
Cause of Injury Code
Accident Description/Cause
Initial Treatment
Date Reported to Employer
Date Reported to Claim Admin
Social Security Number
Employee Last Name
Employee First Name
Employee Middle Initial
Employee Address Line 1
Employee Address Line 2
Employee City
Employee State
Employee Postal Code
Employee Phone
ERROR MESSAGE
X
X
X
X
X
X
MTC invalid for '148'
MTC invalid for 'A49'
State Code Invalid
NCCI Nature Code Invalid
NCCI Part of Body Code Invalid
NCCI Cause of Injury Code Invalid
Gender Code Invalid
Marital Status Code Invalid
Wage Period Code Invalid
Indicator Invalid
Employment Status Code Invalid
Class Code (NCCI or State Spec) Invalid
Industry Code (SIC or NAICS) Invalid
Initial Treatment Code Invalid
Claim Status Code Invalid
Number of Days worked must be 0-7
Days must be 0-6
Return to Work Qualifier Code invalid
Claim Type Code Invalid
Agreement to Compensate Code Invalid
Late Reason Code Invalid
Payment/Adjustment Code Invalid
Benefit/Adjustment Code Invalid
PTD/RE/Recovery Code Invalid
Dep/Payee Relationship Code invalid
Must be numeric (0-9)
Must be a valid date (CCYYMMDD)
Must be A-Z, 0-9, or spaces
Must be a valid time (HHMMSS)
Must be valid on Zip Code Table
Must be <= Date of Injury
Must be >= Date of Injury
Must be >= Date Disability Began
Must be <= Date of Death
Must be <= Maintenance Type Code
date
Must be >= Start date
No match on database
All digits cannot be the same
Must be <= Current date
Not statutorily valid
Receiver ID Invalid
Value is > than required by jurisdiction
Value is < than required by jurisdiction
004
005
006
007
008
009
010
011
012
013
014
015
016
017
018
019
020
021
022
023
024
025
026
027
028
029
030
031
032
033
034
035
036
039
040
041
042
043
044
045
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Reinstated but not suspended
Duplicate First Report (148)
Duplicate Initial Payment (A49)
No matching Subsequent report (A49)
Reduced Earnings prior to Initial
Payment
Suspension prior to Initial Payment
No matching FROI (148)
Must be valid occurence for segment
Must be <= Date of Hire
Detail Record Count not = # records
recv'd
Duplicate transmission/transaction
Code/ID invalid
Value not consistent w/ value prev
reported
Previous supporting docs not received
Previous supporting docs not recv'd
Event Criteria not met
Required segment not present
Invalid event sequence/relationship
Invalid data sequence/relationship
Corresponding report/data not found
Invalid record count
Must be >= Policy Effective Date
Must be <= Policy Expiration Date
No Leading/Embedded Spaces
047
048
049
050
051
052
053
054
055
057
058
060
061
062
063
064
065
066
067
068
100
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
060
059
056
Interchange Version ID invalid
046
038
037
Transaction Set ID Invalid
X
003
X
002
Mandatory field not present
IAIABC
DN
0000
0001
0002
0003
0004
0005
0006
0007
0008
0009
0010
0011
0012
0013
0014
0015
0016
0017
0018
0019
0020
0021
0022
0023
0024
0025
0026
0027
0028
0029
0030
0031
0032
0033
0034
0035
0036
0037
0038
0039
0040
0041
0042
0043
0044
0045
0046
0047
0048
0049
0050
0051
001
IAIABC
Claims Release 1 Edit Matrix Table
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Revised Februaray 15,2002
© IAIABC 2011
IAIABC DATA ELEMENT NAME
Employee Date of Birth
Gender Code
Marital Status Code
Number of Dependents
Date Disability Began
Employee Date of Death
Employment Status Code
Class Code
Occupation Description
Date of Hire
Wage
Wage Period
Number Days Worked
Date Last Day Worked
Full Wages Paid for Date of Inj Ind
Salary Continued Indicator
Date of Return to Work
Pre-Existing Disability
Date of MMI
RTW Qualifer
Date Release/Return to Work
Claim Status
Claim Type
Agreement to Comp. Code
Date of Representation
Late Reason Code
Num. Permanent Impairments
Num. Payment/Adjustments
Num. Benefit/Adjustments
Num. PTD/Reduced Earnings
Num. Death Dep/Payee Rel
Perm. Impairment Body Part
Perm. Impairment Percentage
Payment/Adjustment Code
Payment/Adj. Paid to Date
Payment/Adjustment Amount
Payment/Adj. Start Date
Payment/Adj. End Date
Payment/Adj. Weeks Paid
Payment/Adj. Days Paid
Benefit/Adjustment Code
Benefit/Adjustment Amount
Benefit/Adj. Start Date
PTD/RE/Recovery Code
PTD/RE/Recovery Amnt
Dependent Payee Relationship
Sender ID
Receiver ID
Date Transmission Sent
Time Transmission Sent
Original Transmission Date
Original Transmission Time
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
MTC invalid for '148'
MTC invalid for 'A49'
State Code Invalid
NCCI Nature Code Invalid
NCCI Part of Body Code Invalid
NCCI Cause of Injury Code Invalid
Gender Code Invalid
Marital Status Code Invalid
Wage Period Code Invalid
Indicator Invalid
Employment Status Code Invalid
Class Code (NCCI or State Spec) Invalid
Industry Code (SIC or NAICS) Invalid
Initial Treatment Code Invalid
Claim Status Code Invalid
Number of Days worked must be 0-7
Days must be 0-6
Return to Work Qualifier Code invalid
Claim Type Code Invalid
Agreement to Compensate Code Invalid
Late Reason Code Invalid
Payment/Adjustment Code Invalid
Benefit/Adjustment Code Invalid
PTD/RE/Recovery Code Invalid
Dep/Payee Relationship Code invalid
Must be numeric (0-9)
Must be a valid date (CCYYMMDD)
Must be A-Z, 0-9, or spaces
Must be a valid time (HHMMSS)
Must be valid on Zip Code Table
Must be <= Date of Injury
Must be >= Date of Injury
Must be >= Date Disability Began
Must be <= Date of Death
Must be <= Maintenance Type Code
date
Must be >= Start date
No match on database
All digits cannot be the same
Must be <= Current date
Not statutorily valid
Receiver ID Invalid
Value is > than required by jurisdiction
Value is < than required by jurisdiction
Interchange Version ID invalid
Reinstated but not suspended
Duplicate First Report (148)
Duplicate Initial Payment (A49)
No matching Subsequent report (A49)
Reduced Earnings prior to Initial
Payment
Suspension prior to Initial Payment
No matching FROI (148)
Must be valid occurence for segment
Must be <= Date of Hire
Detail Record Count not = # records
recv'd
Duplicate transmission/transaction
Code/ID invalid
Value not consistent w/ value prev
reported
Previous supporting docs not received
Previous supporting docs not recv'd
Event Criteria not met
Required segment not present
Invalid event sequence/relationship
Invalid data sequence/relationship
Corresponding report/data not found
Invalid record count
Must be >= Policy Effective Date
Must be <= Policy Expiration Date
No Leading/Embedded Spaces
003
004
005
006
007
008
009
010
011
012
013
014
015
016
017
018
019
020
021
022
023
024
025
026
027
028
029
030
031
032
033
034
035
036
X
X
X
X
X
X
039
040
041
042
043
044
045
046
047
048
049
050
X
X
X
X
053
054
055
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
058
060
061
062
063
064
065
066
067
068
100
060
059
057
056
052
051
038
037
Transaction Set ID Invalid
002
ERROR MESSAGE
Mandatory field not present
IAIABC
DN
0052
0053
0054
0055
0056
0057
0058
0059
0060
0061
0062
0063
0064
0065
0066
0067
0068
0069
0070
0071
0072
0073
0074
0075
0076
0077
0078
0079
0080
0081
0082
0083
0084
0085
0086
0087
0088
0089
0090
0091
0092
0093
0094
0095
0096
0097
0098
0099
0100
0101
0102
0103
001
IAIABC
Claims Release 1 Edit Matrix Table
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Revised Februaray 15,2002
© IAIABC 2011
IAIABC DATA ELEMENT NAME
Test/Production Indicator
Interchange Version ID
Detail Record Count
Record Sequence Number
Date Processed
Time Processed
Acknowledgment Transaction Set ID
Application Acknowledgement Code
Request Code (Purpose)
Free Form Text
Number of Errors
Element Number
Element Error Number
Variable Segment Number
X
X
X
X
X
X
X
X
MTC invalid for '148'
MTC invalid for 'A49'
State Code Invalid
NCCI Nature Code Invalid
NCCI Part of Body Code Invalid
NCCI Cause of Injury Code Invalid
Gender Code Invalid
Marital Status Code Invalid
Wage Period Code Invalid
Indicator Invalid
Employment Status Code Invalid
Class Code (NCCI or State Spec) Invalid
Industry Code (SIC or NAICS) Invalid
Initial Treatment Code Invalid
Claim Status Code Invalid
Number of Days worked must be 0-7
Days must be 0-6
Return to Work Qualifier Code invalid
Claim Type Code Invalid
Agreement to Compensate Code Invalid
Late Reason Code Invalid
Payment/Adjustment Code Invalid
Benefit/Adjustment Code Invalid
PTD/RE/Recovery Code Invalid
Dep/Payee Relationship Code invalid
Must be numeric (0-9)
Must be a valid date (CCYYMMDD)
Must be A-Z, 0-9, or spaces
Must be a valid time (HHMMSS)
Must be valid on Zip Code Table
Must be <= Date of Injury
Must be >= Date of Injury
Must be >= Date Disability Began
Must be <= Date of Death
Must be <= Maintenance Type Code
date
Must be >= Start date
No match on database
All digits cannot be the same
Must be <= Current date
Not statutorily valid
Receiver ID Invalid
Value is > than required by jurisdiction
Value is < than required by jurisdiction
Interchange Version ID invalid
Reinstated but not suspended
Duplicate First Report (148)
Duplicate Initial Payment (A49)
No matching Subsequent report (A49)
Reduced Earnings prior to Initial
Payment
Suspension prior to Initial Payment
No matching FROI (148)
Must be valid occurence for segment
Must be <= Date of Hire
Detail Record Count not = # records
recv'd
Duplicate transmission/transaction
Code/ID invalid
Value not consistent w/ value prev
reported
Previous supporting docs not received
Previous supporting docs not recv'd
Event Criteria not met
Required segment not present
Invalid event sequence/relationship
Invalid data sequence/relationship
Corresponding report/data not found
Invalid record count
Must be >= Policy Effective Date
Must be <= Policy Expiration Date
No Leading/Embedded Spaces
003
004
005
006
007
008
009
010
011
012
013
014
015
016
017
018
019
020
021
022
023
024
025
026
027
028
029
030
031
032
033
034
035
036
039
040
041
042
043
044
045
046
047
048
049
050
053
054
055
X
X
058
X
X
X
X
X
X
X
X
X
X
X
060
061
062
063
064
065
066
067
068
100
060
059
057
056
052
051
038
037
Transaction Set ID Invalid
002
ERROR MESSAGE
Mandatory field not present
IAIABC
DN
0104
0105
0106
0107
0108
0109
0110
0111
0112
0113
0114
0115
0116
0117
001
IAIABC
Claims Release 1 Edit Matrix Table
X
X
X
X
X
X
Revised Februaray 15,2002