X12 837P Professional Claim

1. Interchange and functional group envelopes

   ISA/IEA, GS/GE and ST/SE envelopes, delimiters, control numbers and the 999 acknowledgment.

2. Hierarchical loop structure

   Loop 2000A billing provider, 2000B subscriber and 2000C patient hierarchy via HL segments.

3. Claim loop 2300

   CLM claim submission, HI diagnosis codes, REF identifiers, DTP dates and claim frequency code.

4. Service lines 2400

   LX line counter, SV1 procedure code with modifiers, units, place of service and diagnosis pointers.

5. Names and providers 2010 loops

   Billing, rendering, referring and service facility providers, NPI in NM1, taxonomy in PRV, and subscriber and payer names.

6. Coordination of benefits

   Loops 2320 and 2330 with SBR payer responsibility and CAS adjustments from prior payers.

7. Payer companion guides

   Payer-specific companion guides layered over the HIPAA 5010 implementation guide.

8. Completing professional claims

   Medicare Claims Processing Manual coverage of physician and non-physician practitioner billing rules.

Each section links to the official page. Titles and summaries by Extra Credit; the docs belong to their authors.