TR3
Technical Report Type 3. The official implementation guide for a HIPAA Transaction Set, published by ASC X12 and adopted by CMS.
Definition
The TR3 (Technical Report Type 3) is a document published by ASC X12 and adopted by the Centers for Medicare & Medicaid Services (CMS). It describes, for every HIPAA Transaction Set (270/271, 276/277, 278, 820, 834, 835, 837), how regulated data must be encoded in X12: mandatory segments, allowed qualifiers, loop codes, separator rules, syntactic and semantic validation.
Origin
TR3s have been produced since 2000 to give regulatory force to X12 Transaction Sets under the HIPAA Administrative Simplification Provisions (45 CFR Part 162). The most deployed versions are 005010X279 (Eligibility 270/271), 005010X220 (Enrollment 834), 005010X221 (Payment 835), 005010X222 (Claim 837P). The planned move to 008020 has been postponed several times by CMS.
Example in context
A typical TR3 spans several hundred pages. The 005010X222 Health Care Claim Professional (837P), for example, details for each loop (2000A Billing Provider, 2000B Subscriber, 2300 Claim) the mandatory codes, segments to use, and business rules: CPT procedure code, ICD-10 for diagnosis, ten-digit NPI for the prescriber. Any deviation is rejected by the clearing house during HIPAA pre-validation.