Common use of Drug Records Clause in Contracts

Drug Records. ‌ For Non-MSP drug processing, the BCRC will apply error checks and provide the results to the Partner in the response file. The SP edits that would be generated as a result of errors on drug records are as follows: *SP 12 Invalid Medicare ID (HICN or MBI). Field must contain alpha or numeric characters. Field cannot be blank or contain spaces. *SP 13 Invalid Beneficiary Surname. Field must contain alpha characters. Field cannot be blank, contain spaces or numeric characters. *SP 14 Invalid Beneficiary First Name Initial. Field must contain alpha characters. Field cannot be blank, contain spaces, numeric characters or punctuation marks. *SP 15 Invalid Beneficiary Date of Birth. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Day of the month must be correct. For example, if month = 02 and date = 30, the record will reject. *SP 16 Invalid Beneficiary Sex Code. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Acceptable numeric characters include the following: 1 = Male 2 = Female *SP 19 Invalid Transaction Type. Field must contain numeric characters. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record 1 = Delete Record 2 = Update Record *SP 24 Invalid Coverage Type. Field may contain alpha or numeric characters. Field cannot be blank. Applicable values are: A, J, K, U, V, W, X, Y, Z, 4, 5, 6 for MSP layout; U, V, W, X, Y, Z, 4, 5, 6 for Non-MSP layout. SP 25 Invalid or no insurer name supplied when the submitted Action Type is ‘D’ (Drug Reporting record) or ‘S’ (Subsidy reporting record). Field cannot be blank or contain only numeric characters and spaces. On the Non-MSP Input Detail Record, when the submitted Action Type (Field 20) is D (Drug Reporting record) or S (Subsidy Reporting record), RREs must submit the Insurer Name (Field 27). If an attempt is made to convert an S record to a D record and the insurer name is missing or invalid, the SP 25 error will be received. *SP 31 Invalid Effective Date. Field must contain numeric characters. Field cannot be blank, contain spaces, alpha characters or all zeros. Number of days must correspond with the particular month. *SP 32 Invalid MSP Termination Date. Field must contain numeric characters. Date must correspond with the particular month – CCYYMMDD. For example, 02/27/1997 is acceptable, but not 02/30/1997. Cannot be earlier than the MSP effective date. If there is no termination date (coverage is still active), must use zeros (not spaces) in this field. *SP 34 Invalid Subscriber First Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. Only alpha characters used when subscriber is identified. *SP 35 Invalid Subscriber Last Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. May use spaces instead of apostrophe. Only alpha characters may be used when subscriber is identified. SP 49 No valid record exists for delete request. Attempt to delete a nonexistent MSP record will cause a reject. *SP 52 Invalid patient relationship code SP 62 Incoming termination date is less than effective date. MSP termination date must be greater than the effective date. Additionally, the BCRC will provide specific RX coding errors: *RX 01 Missing RX ID *RX 02 Missing RX BIN *RX 03 Missing RX Group Number *RX 04 Missing Group Policy Number *RX 05 Missing Individual Policy Number *RX 06 Missing or Invalid Retiree Drug Subsidy Application Number *RX 07 Beneficiary does not have Part D enrollment *RX 09 Invalid action code *RX 10 Record not found for delete *RX 11 Record not found for update *RX 12 Invalid Supplemental Type • Codes marked with an asterisk (*) are "front end" consistency edits. These codes show conditions on the face of the record that are unrecognizable or unallowable for that field. • Codes that do not have an asterisk (*) show discrepancies that result from information on the submitted record conflicting with or not matching the information on CMS’ systems.

Drug Records. ‌ For Non-MSP drug processing, the BCRC will apply error checks and provide the results to the Partner in the response file. The SP edits that would be generated as a result of errors on drug records are as follows: *SP 12 Invalid Medicare ID (HICN or MBI). Field must contain alpha or numeric characters. Field cannot be blank or contain spaces. *SP 13 Invalid Beneficiary Surname. Field must contain alpha characters. Field cannot be blank, contain spaces or numeric characters. *SP 14 Invalid Beneficiary First Name Initial. Field must contain alpha characters. Field cannot be blank, contain spaces, numeric characters or punctuation marks. *SP 15 Invalid Beneficiary Date of Birth. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Day of the month must be correct. For example, if month = 02 and date = 30, the record will reject. *SP 16 Invalid Beneficiary Sex Code. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Acceptable numeric characters include the following: 1 = Male 2 = Female *SP 19 Invalid Transaction Type. Field must contain numeric characters. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record 1 = Delete Record 2 = Update Record *SP 24 Invalid Coverage Type. Field may contain alpha or numeric characters. Field cannot be blank. Applicable values are: A, J, K, U, V, W, X, Y, Z, 4, 5, 6 for MSP layout; U, V, W, X, Y, Z, 4, 5, 6 for Non-MSP layout. SP 25 Invalid or no insurer name supplied when the submitted Action Type is ‘D’ (Drug Reporting record) or ‘S’ (Subsidy reporting record). Field cannot be blank or contain only numeric characters and spaces. On the Non-MSP Input Detail Record, when the submitted Action Type (Field 20) is D ‘D’ (Drug Reporting record) or S ‘S’ (Subsidy Reporting record), RREs must submit the Insurer Name (Field 27). If an attempt is made to convert an S ‘S’ record to a D ‘D’ record and the insurer name is missing or invalid, the SP 25 error will be received. *SP 31 Invalid Effective Date. Field must contain numeric characters. Field cannot be blank, contain spaces, alpha characters or all zeros. Number of days must correspond with the particular month. *SP 32 Invalid MSP Termination Date. Field must contain numeric characters. Date must correspond with the particular month – CCYYMMDD. For example, 02/27/1997 is acceptable, but not 02/30/1997. Cannot be earlier than the MSP effective date. If there is no termination date (coverage is still active), must use zeros (not spaces) in this field. *SP 34 Invalid Subscriber First Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. Only alpha characters used when subscriber is identified. *SP 35 Invalid Subscriber Last Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. May use spaces instead of apostrophe. Only alpha characters may be used when subscriber is identified. SP 49 No valid record exists for delete request. Attempt to delete a nonexistent MSP record will cause a reject. *SP 52 Invalid patient relationship code SP 62 Incoming termination date is less than effective date. MSP termination date must be greater than the effective date. Additionally, the BCRC will provide specific RX coding errors: *RX 01 Missing RX ID *RX 02 Missing RX BIN *RX 03 Missing RX Group Number *RX 04 Missing Group Policy Number *RX 05 Missing Individual Policy Number *RX 06 Missing or Invalid Retiree Drug Subsidy Application Number *RX 07 Beneficiary does not have Part D enrollment *RX 09 Invalid action code *RX 10 Record not found for delete *RX 11 Record not found for update *RX 12 Invalid Supplemental Type • Codes marked with an asterisk (*) are "front end" consistency edits. These codes show conditions on the face of the record that are unrecognizable or unallowable for that field. • Codes that do not have an asterisk (*) show discrepancies that result from information on the submitted record conflicting with or not matching the information on CMS’ systems’s Systems.

Drug Records. ‌ For Non-MSP drug processing, the BCRC will apply error checks and provide the results to the Partner in the response file. The SP edits that would be generated as a result of errors on drug records are as follows: *SP 12 Invalid Medicare ID (HICN or MBI). Field must contain alpha or numeric characters. Field cannot be blank or contain spaces. *SP 13 Invalid Beneficiary Surname. Field must contain alpha characters. Field cannot be blank, contain spaces or numeric characters. *SP 14 Invalid Beneficiary First Name Initial. Field must contain alpha characters. Field cannot be blank, contain spaces, numeric characters or punctuation marks. *SP 15 Invalid Beneficiary Date of Birth. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Day of the month must be correct. For example, if month = 02 and date = 30, the record will reject. *SP 16 Invalid Beneficiary Sex Code. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Acceptable numeric characters include the following: 1 = Male 2 = Female *SP 19 Invalid Transaction Type. Field must contain numeric characters. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record 1 = Delete Record 2 = Update Record *SP 24 Invalid Coverage Type. Field may contain alpha or numeric characters. Field cannot be blank. Applicable values are: A, J, K, U, V, W, X, Y, Z, 4, 5, 6 for MSP layout; U, V, W, X, Y, Z, 4, 5, 6 for Non-MSP layout. SP 25 Invalid or no insurer name supplied when the submitted Action Type is ‘D’ (Drug Reporting record) or ‘S’ (Subsidy reporting record). Field cannot be blank or contain only numeric characters and spaces. On the Non-MSP Input Detail Record, when the submitted Action Type (Field 20) is D (Drug Reporting record) or S (Subsidy Reporting record), RREs must submit the Insurer Name (Field 27). If an attempt is made to convert an S record to a D record and the insurer name is missing or invalid, the SP 25 error will be received. *SP 31 Invalid Effective Date. Field must contain numeric characters. Field cannot be blank, contain spaces, alpha characters or all zeros. Number of days must correspond with the particular month. *SP 32 Invalid MSP Termination Date. Field must contain numeric characters. Date must correspond with the particular month – CCYYMMDD. For example, 02/27/1997 is acceptable, but not 02/30/1997. Cannot be earlier than the MSP effective date. If there is no termination date (coverage is still active), must use zeros (not spaces) in this field. *SP 34 Invalid Subscriber First Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. Only alpha characters used when subscriber is identified. *SP 35 Invalid Subscriber Last Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. May use spaces instead of apostrophe. Only alpha characters may be used when subscriber is identified. SP 49 No valid record exists for delete request. Attempt to delete a nonexistent MSP record will cause a reject. *SP 52 Invalid patient relationship code SP 62 Incoming termination date is less than effective date. MSP termination date must be greater than the effective date. Additionally, the BCRC will provide specific RX coding errors: *RX 01 Missing RX ID *RX 02 Missing RX BIN *RX 03 Missing RX Group Number *RX 04 Missing Group Policy Number *RX 05 Missing Individual Policy Number *RX 06 Missing or Invalid Retiree Drug Subsidy Application Number *RX 07 Beneficiary does not have Part D enrollment *RX 09 Invalid action code *RX 10 Record not found for delete *RX 11 Record not found for update *RX 12 Invalid Supplemental Type *RX-19 Ovrelapping Rx coverage • Codes marked with an asterisk (*) are "front end" consistency edits. These codes show conditions on the face of the record that are unrecognizable or unallowable for that field. • Codes that do not have an asterisk (*) show discrepancies that result from information on the submitted record conflicting with or not matching the information on CMS’ systems.

Drug Records. ‌ For Non-MSP drug processing, the BCRC will apply error checks and provide the results to the Partner in the response file. The SP edits that would be generated as a result of errors on drug records are as follows: *SP 12 Invalid Medicare ID (HICN or MBI). Field must contain alpha or numeric characters. Field cannot be blank or contain spaces. *SP 13 Invalid Beneficiary Surname. Field must contain alpha characters. Field cannot be blank, contain spaces or numeric characters. *SP 14 Invalid Beneficiary First Name Initial. Field must contain alpha characters. Field cannot be blank, contain spaces, numeric characters or punctuation marks. *SP 15 Invalid Beneficiary Date of Birth. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Day of the month must be correct. For example, if month = 02 and date = 30, the record will reject. *SP 16 Invalid Beneficiary Sex Code. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Acceptable numeric characters include the following: 1 = Male 2 = Female *SP 19 Invalid Transaction Type. Field must contain numeric characters. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record 1 = Delete Record 2 = Update Record *SP 24 Invalid Coverage Type. Field may contain alpha or numeric characters. Field cannot be blank. Applicable values are: A, J, K, U, V, W, X, Y, Z, 4, 5, 6 for MSP layout; U, V, W, X, Y, Z, 4, 5, 6 for Non-MSP layout. SP 25 Invalid or no insurer name supplied when the submitted Action Type is ‘D’ (Drug Reporting record) or ‘S’ (Subsidy reporting record). Field cannot be blank or contain only numeric characters and spaces. On the Non-MSP Input Detail Record, when the submitted Action Type (Field 20) is D (Drug Reporting record) or S (Subsidy Reporting record), RREs must submit the Insurer Name (Field 27). If an attempt is made to convert an S record to a D record and the insurer name is missing or invalid, the SP 25 error will be received. *SP 31 Invalid Effective Date. Field must contain numeric characters. Field cannot be blank, contain spaces, alpha characters or all zeros. Number of days must correspond with the particular month. *SP 32 Invalid MSP Termination Date. Field must contain numeric characters. Date must correspond with the particular month – CCYYMMDD. For example, 02/27/1997 is acceptable, but not 02/30/1997. Cannot be earlier than the MSP effective date. If there is no termination date (coverage is still active), must use zeros (not spaces) in this field. *SP 34 Invalid Subscriber First Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. Only alpha characters used when subscriber is identified. *SP 35 Invalid Subscriber Last Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. May use spaces instead of apostrophe. Only alpha characters may be used when subscriber is identified. SP 49 No valid record exists for delete request. Attempt to delete a nonexistent MSP record will cause a reject. *SP 52 Invalid patient relationship code SP 62 Incoming termination date is less than effective date. MSP termination date must be greater than the effective date. Additionally, the BCRC will provide specific RX coding errors: *RX 01 Missing RX ID *RX 02 Missing RX BIN *RX 03 Missing RX Group Number *RX 04 Missing Group Policy Number *RX 05 Missing Individual Policy Number *RX 06 Missing or Invalid Retiree Drug Subsidy Application Number *RX 07 Beneficiary does not have Part D enrollment *RX 09 Invalid action code *RX 10 Record not found for delete *RX 11 Record not found for update *RX 12 Invalid Supplemental Type • Codes marked with an asterisk (*) are "front end" consistency edits. These codes show conditions on the face of the record that are unrecognizable or unallowable for that field. • Codes that do not have an asterisk (*) show discrepancies that result from information on the submitted record conflicting with or not matching the information on CMS’ systems’s Systems.

Drug Records. ‌ For Non-MSP drug processing, the BCRC COBC will apply error checks and provide the results to the Partner in the response file. The SP edits that would be generated as a result of errors on drug records are as follows: *SP 12 Invalid Medicare ID (HICN or MBI)HIC Number. Field must contain alpha or numeric characters. Field cannot be blank or contain spaces. *SP 13 Invalid Beneficiary Surname. Field must contain alpha characters. Field cannot be blank, contain spaces or numeric characters. *SP 14 Invalid Beneficiary First Name Initial. Field must contain alpha characters. Field cannot be blank, contain spaces, numeric characters or punctuation marks. *SP 15 Invalid Beneficiary Date of Birth. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Day of the month must be correct. For example, if month = 02 and date = 30, the record will reject. *SP 16 Invalid Beneficiary Sex Code. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Acceptable numeric characters include the following: 1 = Male 2 = Female *SP 19 Invalid Transaction Type. Field must contain numeric characters. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record 1 = Delete Record 2 = Update Record *SP 24 Invalid Coverage Type. Field may contain alpha or numeric characters. Field cannot be blank. Applicable values are: A, J, K, U, V, W, X, Y, Z, 4, 5, 6 for MSP layout; U, V, W, X, Y, Z, 4, 5, 6 for Non-MSP layout. SP 25 Invalid or no insurer name supplied when the submitted Action Type is ‘D’ (Drug Reporting record) or ‘S’ (Subsidy reporting record). Field cannot be blank or contain only numeric characters and spaces. On the Non-MSP Input Detail Record, when the submitted Action Type (Field 20) is D (Drug Reporting record) or S (Subsidy Reporting record), RREs must submit the Insurer Name (Field 27). If an attempt is made to convert an S record to a D record and the insurer name is missing or invalid, the SP 25 error will be received. *SP 31 Invalid Effective Date. Field must contain numeric characters. Field cannot be blank, contain spaces, alpha characters or all zeros. Number of days must correspond with the particular month. *SP 32 Invalid MSP Termination Date. Field must contain numeric characters. Date must correspond with the particular month – CCYYMMDD. For example, 02/27/1997 is acceptable, but not 02/30/1997. Cannot be earlier than the MSP effective date. If there is no termination date (coverage is still active), must use zeros (not spaces) in this field. *SP 34 Invalid Subscriber First Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. Only alpha characters used when subscriber is identified. *SP 35 Invalid Subscriber Last Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. May use spaces instead of apostrophe. Only alpha characters may be used when subscriber is identified. SP 49 No valid record exists for delete request. Attempt to delete a nonexistent MSP record will cause a reject. *SP 52 Invalid patient relationship code SP 62 Incoming termination date is less than effective date. MSP termination date must be greater than the effective date. Additionally, the BCRC COBC will provide specific RX coding errors: *RX 01 Missing RX ID *RX 02 Missing RX BIN *RX 03 Missing RX Group Number *RX 04 Missing Group Policy Number *RX 05 Missing Individual Policy Number *RX 06 Missing or Invalid Retiree Drug Subsidy Application Number *RX 07 Beneficiary does not have Part D enrollment *RX 09 Invalid action code *RX 10 Record not found for delete *RX 11 Record not found for update *RX 12 Invalid Supplemental Type • Codes marked with an asterisk (*) are "front end" consistency edits. These codes show conditions on the face of the record that are unrecognizable or unallowable for that field. • Codes that do not have an asterisk (*) show discrepancies that result from information on the submitted record conflicting with or not matching the information on CMS’ systemsCMS‟s Systems.

Drug Records. ‌ For Non-MSP drug processing, the BCRC will apply error checks and provide the results to the Partner in the response file. The SP edits that would be generated as a result of errors on drug records are as follows: *SP 12 Invalid Medicare ID (HICN or MBI)HIC Number. Field must contain alpha or numeric characters. Field cannot be blank or contain spaces. *SP 13 Invalid Beneficiary Surname. Field must contain alpha characters. Field cannot be blank, contain spaces or numeric characters. *SP 14 Invalid Beneficiary First Name Initial. Field must contain alpha characters. Field cannot be blank, contain spaces, numeric characters or punctuation marks. *SP 15 Invalid Beneficiary Date of Birth. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Day of the month must be correct. For example, if month = 02 and date = 30, the record will reject. *SP 16 Invalid Beneficiary Sex Code. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Acceptable numeric characters include the following: 1 = Male 2 = Female *SP 19 Invalid Transaction Type. Field must contain numeric characters. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record 1 = Delete Record 2 = Update Record *SP 24 Invalid Coverage Type. Field may contain alpha or numeric characters. Field cannot be blank. Applicable values are: A, J, K, U, V, W, X, Y, Z, 4, 5, 6 for MSP layout; U, V, W, X, Y, Z, 4, 5, 6 for Non-MSP layout. SP 25 Invalid or no insurer name supplied when the submitted Action Type is ‘D’ (Drug Reporting record) or ‘S’ (Subsidy reporting record). Field cannot be blank or contain only numeric characters and spaces. On the Non-MSP Input Detail Record, when the submitted Action Type (Field 20) is D (Drug Reporting record) or S (Subsidy Reporting record), RREs must submit the Insurer Name (Field 27). If an attempt is made to convert an S record to a D record and the insurer name is missing or invalid, the SP 25 error will be received. *SP 31 Invalid Effective Date. Field must contain numeric characters. Field cannot be blank, contain spaces, alpha characters or all zeros. Number of days must correspond with the particular month. *SP 32 Invalid MSP Termination Date. Field must contain numeric characters. Date must correspond with the particular month – CCYYMMDD. For example, 02/27/1997 is acceptable, but not 02/30/1997. Cannot be earlier than the MSP effective date. If there is no termination date (coverage is still active), must use zeros (not spaces) in this field. *SP 34 Invalid Subscriber First Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. Only alpha characters used when subscriber is identified. *SP 35 Invalid Subscriber Last Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. May use spaces instead of apostrophe. Only alpha characters may be used when subscriber is identified. SP 49 No valid record exists for delete request. Attempt to delete a nonexistent MSP record will cause a reject. *SP 52 Invalid patient relationship code SP 62 Incoming termination date is less than effective date. MSP termination date must be greater than the effective date. Additionally, the BCRC will provide specific RX coding errors: *RX 01 Missing RX ID *RX 02 Missing RX BIN *RX 03 Missing RX Group Number *RX 04 Missing Group Policy Number *RX 05 Missing Individual Policy Number *RX 06 Missing or Invalid Retiree Drug Subsidy Application Number *RX 07 Beneficiary does not have Part D enrollment *RX 09 Invalid action code *RX 10 Record not found for delete *RX 11 Record not found for update *RX 12 Invalid Supplemental Type • Codes marked with an asterisk (*) are "front end" consistency edits. These codes show conditions on the face of the record that are unrecognizable or unallowable for that field. • Codes that do not have an asterisk (*) show discrepancies that result from information on the submitted record conflicting with or not matching the information on CMS’ systems’s Systems.

Drug Records. ‌ For Non-MSP drug processing, the BCRC COBC will apply error checks and provide the results to the Partner in the response file. The SP edits that would be generated as a result of errors on drug records are as follows: *SP 12 Invalid Medicare ID (HICN or MBI)HIC Number. Field must contain alpha or numeric characters. Field cannot be blank or contain spaces. *SP 13 Invalid Beneficiary Surname. Field must contain alpha characters. Field cannot be blank, contain spaces or numeric characters. *SP 14 Invalid Beneficiary First Name Initial. Field must contain alpha characters. Field cannot be blank, contain spaces, numeric characters or punctuation marks. *SP 15 Invalid Beneficiary Date of Birth. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Day of the month must be correct. For example, if month = 02 and date = 30, the record will reject. *SP 16 Invalid Beneficiary Sex Code. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Acceptable numeric characters include the following: 1 = Male 2 = Female *SP 19 Invalid Transaction Type. Field must contain numeric characters. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record 1 = Delete Record 2 = Update Record *SP 24 Invalid Coverage Type. Field may contain alpha or numeric characters. Field cannot be blank. Applicable values are: A, J, K, U, V, W, X, Y, Z, 4, 5, 6 for MSP layout; U, V, W, X, Y, Z, 4, 5, 6 for Non-MSP layout. SP 25 Invalid or no insurer name supplied when the submitted Action Type is ‘D’ (Drug Reporting record) or ‘S’ (Subsidy reporting record). Field cannot be blank or contain only numeric characters and spaces. On the Non-MSP Input Detail Record, when the submitted Action Type (Field 20) is D (Drug Reporting record) or S (Subsidy Reporting record), RREs must submit the Insurer Name (Field 27). If an attempt is made to convert an S record to a D record and the insurer name is missing or invalid, the SP 25 error will be received. *SP 31 Invalid Effective Date. Field must contain numeric characters. Field cannot be blank, contain spaces, alpha characters or all zeros. Number of days must correspond with the particular month. *SP 32 Invalid MSP Termination Date. Field must contain numeric characters. Date must correspond with the particular month – CCYYMMDD. For example, 02/27/1997 is acceptable, but not 02/30/1997. Cannot be earlier than the MSP effective date. If there is no termination date (coverage is still active), must use zeros (not spaces) in this field. *SP 34 Invalid Subscriber First Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. Only alpha characters used when subscriber is identified. *SP 35 Invalid Subscriber Last Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. May use spaces instead of apostrophe. Only alpha characters may be used when subscriber is identified. SP 49 No valid record exists for delete request. Attempt to delete a nonexistent MSP record will cause a reject. *SP 52 Invalid patient relationship code SP 62 Incoming termination date is less than effective date. MSP termination date must be greater than the effective date. Additionally, the BCRC COBC will provide specific RX coding errors: *RX 01 Missing RX ID *RX 02 Missing RX BIN *RX 03 Missing RX Group Number *RX 04 Missing Group Policy Number *RX 05 Missing Individual Policy Number *RX 06 Missing or Invalid Retiree Drug Subsidy Application Number *RX 07 Beneficiary does not have Part D enrollment *RX 09 Invalid action code *RX 10 Record not found for delete *RX 11 Record not found for update *RX 12 Invalid Supplemental Type • Codes marked with an asterisk (*) are "front end" consistency edits. These codes show conditions on the face of the record that are unrecognizable or unallowable for that field. • Codes that do not have an asterisk (*) show discrepancies that result from information on the submitted record conflicting with or not matching the information on CMS’ systems’s Systems.

Drug Records. ‌ For MSP Drug Only or Non-MSP drug or subsidy processing, the BCRC COBC will apply similar error checks and provide the results to the Partner in the response file. The SP edits that would be generated as a result of errors on drug records are as follows: *SP 12 Invalid Medicare ID (HICN or MBI)HIC Number. Field must contain alpha or numeric characters. Field cannot be blank or contain spaces. *SP 13 Invalid Beneficiary Surname. Field must contain alpha characters. Field cannot be blank, contain spaces or numeric characters. *SP 14 Invalid Beneficiary First Name Initial. Field must contain alpha characters. Field cannot be blank, contain spaces, numeric characters or punctuation marks. *SP 15 Invalid Beneficiary Date of Birth. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Day of the month must be correct. For example, if month = 02 and date = 30, the record will reject. *SP 16 Invalid Beneficiary Sex Code. Field must contain numeric characters. Field cannot be blank, contain spaces or alpha characters. Acceptable numeric characters include the following: 1 = Male 2 = Female *SP 19 Invalid Transaction Type. Field must contain numeric characters. Field cannot be blank, contain alpha characters or spaces. Acceptable numeric characters include the following: 0 = Add Record 1 = Delete Record 2 = Update Record *SP 24 Invalid Coverage Type. Field may contain alpha or numeric characters. Field cannot be blank. Applicable values are: A, J, K, U, V, W, X, Y, Z, 4, 5, 6 for MSP layout; U, V, W, X, Y, Z, 4, 5, 6 for Non-MSP layout. SP 25 Invalid or no insurer name supplied when the submitted Action Type is ‘D’ (Drug Reporting record) or ‘S’ (Subsidy reporting record). Field cannot be blank or contain only numeric characters and spaces. On the Non-MSP Input Detail Record, when the submitted Action Type (Field 20) is D (Drug Reporting record) or S (Subsidy Reporting record), RREs must submit the Insurer Name (Field 27). If an attempt is made to convert an S record to a D record and the insurer name is missing or invalid, the SP 25 error will be received. *SP 31 Invalid Effective Date. Field must contain numeric characters. Field cannot be blank, contain spaces, alpha characters or all zeros. Number of days must correspond with the particular month. *SP 32 Invalid MSP Termination Date. Field must contain numeric characters. Date must correspond with the particular month – CCYYMMDD. For example, 02/27/1997 is acceptable, but not 02/30/1997. Cannot be earlier than the MSP effective date. If there is no termination date (coverage is still active), must use zeros (not spaces) in this field. *SP 34 Invalid Subscriber First Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. Only alpha characters used when subscriber is identified. *SP 35 Invalid Subscriber Last Name. Field may contain alpha characters. If field is not used, field must contain spaces. Field cannot be blank or contain numeric characters. May use spaces instead of apostrophe. Only alpha characters may be used when subscriber is identified. SP 49 No valid record exists for delete request. Attempt to delete a nonexistent MSP record will cause a reject. *SP 52 Invalid patient relationship code SP 62 Incoming termination date is less than effective date. MSP termination date must be greater than the effective date. Additionally, the BCRC COBC will provide specific RX coding errors: *RX 01 Missing RX ID *RX 02 Missing RX BIN *RX 03 Missing RX Group Number *RX 04 Missing Group Policy Number *RX 05 Missing Individual Policy Number *RX 06 Missing or Invalid Retiree Drug Subsidy Application Number *RX 07 Beneficiary does not have Part D enrollment *RX 09 Invalid action code *RX 10 Record not found for delete *RX 11 Record not found for update *RX 12 Invalid Supplemental Type • Codes marked with an asterisk (*) are "front end" consistency edits. These codes show conditions on the face of the record that are unrecognizable or unallowable for that field. • Codes that do not have an asterisk (*) show discrepancies that result from information on the submitted record conflicting with or not matching the information on CMS’ systems’s Systems.