# EDI 277 Claim Status Response and 277CA Guide
> EDI 277 claim status response explained: STC category and status codes, payment fields, the 277CA acknowledgment, and a live example.
The EDI 277 is the X12 Health Care Claim Status Response a health plan sends to answer a 276 claim status request. For each claim it returns STC status codes, such as finalized and paid or pending review, plus charges, payment amounts and the payer's claim number. A variant, the 277CA, acknowledges claims at intake.
**The EDI 277 tells a billing team what happened to a claim in a code they can route.** It answers a [276 claim status request](/guides/edi/276-claim-status-request), and every claim in it carries an `STC` segment with a status category (finalized, pending, acknowledged, rejected) and a more specific status code. Read `STC` correctly and you know whether to wait for the [835](/guides/edi/835-health-care-claim-payment-advice), send records, fix and resubmit, or appeal.
This guide covers the 277's structure, the `STC` segment element by element, the most common category and status codes, the 277CA claim acknowledgment that shares the 277 number, a live example built from fictional data, and the mistakes teams make acting on 277s. It describes the X12 structure only; it is not legal, billing or compliance advice.
## What Is an EDI 277?
**An EDI 277 is the Health Care Claim Status Response transaction set defined by [ASC X12](https://x12.org/examples/005010x212), used by a health plan to report the status of claims a provider asked about.** For HIPAA covered entities, [45 CFR 162.1402](https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-162/subpart-N/section-162.1402) adopts the X12 276/277 Technical Report Type 3 `005010X212` (with its errata `005010X212E1`) as the claim status standard. The 277 response carries `005010X212` in `GS08` and `ST03`, and its functional group code in `GS01` is `HN`.
Authoritative references for 277 work:
- The [X12 005010X212 examples](https://x12.org/examples/005010x212) show a 277 answering three claims: one pending, one finalized, one denied at the line level
- X12 maintains the code lists the `STC` segment uses: the [Claim Status Category Codes](https://x12.org/codes/claim-status-category-codes) and the [Claim Status Codes](https://x12.org/codes/claim-status-codes). Both are updated on a regular cycle, so load them from the source rather than hard-coding a copy
- HHS adopted CAQH CORE operating rules for the claim status transaction, listed in [45 CFR 162.920](https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-162/subpart-I/section-162.920), with compliance from January 1, 2013 per [CMS](https://www.cms.gov/priorities/key-initiatives/burden-reduction/administrative-simplification/operating-rules)
- The 277CA has its own TR3, `005010X214`, with examples on [X12's 005010X214 page](https://x12.org/examples/005010x214)
**Who sends it?** The health plan, or its claims vendor. A 277CA can also come from a clearinghouse.
**Who receives it?** The information receiver named in the 276, usually the clearinghouse or billing service, which passes it to the provider.
**When is it sent?** In reply to each 276: real time or batch. A 277CA is sent after an 837 is received, without a request.
## The 277 and the 277CA: Same Number, Different Jobs
Both are X12 277 transaction sets, but they follow different implementation guides and answer different questions.
| | 277 Claim Status Response | 277CA Claim Acknowledgment |
|---|---|---|
| **Implementation guide** | `005010X212` | `005010X214` |
| **Triggered by** | A 276 request | Receipt of an 837 claim file |
| **Question it answers** | "Where is this claim now?" | "Did this claim get into your adjudication system?" |
| **Typical statuses** | Finalized, pending, not found | Accepted (`A1`, `A2`) or rejected at intake (`A3`, `A6`, `A7`) |
| **`BHT01` structure** | `0010` | `0085` |
| **Patient level `HL03`** | `22` subscriber, `23` dependent | `PT` patient |
| **HIPAA status** | Adopted standard under 45 CFR 162.1402 | Not one of the standards named in 45 CFR Part 162; [CMS's 5010 schedule](https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/Versions5010andD0/Downloads/Errata_Req_and_Testing.pdf) lists it among Medicare fee-for-service transactions |
The order on the claim side is: 837 sent, [999](/guides/edi/999-implementation-acknowledgment) back (file-level syntax), 277CA back (claim-level acceptance), then 835 or 277 later. A claim rejected on a 277CA never entered adjudication, so a 276 about it will usually come back "not found." Fix and resubmit it instead.
In the 277CA, `STC03` also carries an action code: the X12 example uses `WQ` (accept) on accepted claims and `U` (reject) on rejected ones.
## Interactive Example: 277 With a Paid Claim and a Pending Claim
The fictional health plan answers the fictional practice's 276 for two claims. JOHN SAMPLE's claim is finalized and paid: `STC*F1:65` with the $285.00 charge, a $198.40 payment, the adjudication date, payment by ACH, the EFT effective date and an EFT trace number. JANE SAMPLE's claim is pending payer review: `STC*P2:46` (internal review/audit). Both carry the payer's claim control number in `REF*1K`. Every name, ID and amount is fictional, and `ISA15` is `T` (test).
Use the **Plain English** tab for a readable summary, or click any segment to break it down element by element.
## 277 Structure at a Glance
The 277 mirrors the 276 hierarchy (`BHT01` = `0010`) and adds status at each claim.
| Loop | Segment | Name | Notes |
|---|---|---|---|
| Header | **ST** | Transaction Set Header | `ST01` = `277`, `ST03` = `005010X212` |
| Header | **BHT** | Beginning of Hierarchical Transaction | `BHT02` = `08` and `BHT06` = `DG` in the X12 example |
| 2000A / 2100A | **HL / NM1** | Information source (payer) | `HL03` = `20`, `NM101` = `PR` |
| 2000B / 2100B | **HL / NM1** | Information receiver | `HL03` = `21`, `NM101` = `41` |
| 2000C / 2100C | **HL / NM1** | Service provider | `HL03` = `19`, `NM101` = `1P` |
| 2000D / 2100D | **HL / NM1** | Subscriber | `HL03` = `22`, `NM101` = `IL` |
| 2200D | **TRN** | Claim Status Tracking Number | `TRN01` = `2`, echoing the 276 trace |
| 2200D | **STC** | Claim Level Status Information | Repeats if there are several statuses |
| 2200D | **REF** | Claim identifiers | `1K` payer claim control number, `EJ` patient control number, `BLT` bill type |
| 2200D | **DTP** | Claim Service Date | `472` |
| 2220D | **SVC / STC / REF / DTP** | Service line status | When the payer reports line-level status |
| 2000E-2220E | | Dependent levels | Patient is a dependent, `NM101` = `QC` |
| Trailer | **SE** | Transaction Set Trailer | Segment count and control number |
## Key Segments Explained
### TRN: Matching the Answer to the Question
```
TRN*2*SMPCLM1001~
```
`TRN01` = `2` (referenced transaction trace number) and `TRN02` is the trace you sent in the 276. Match each claim's status to your open claim on this value.
### STC: Status Information
```
STC*F1:65*20261104**285*198.4*20261104*ACH*20261106*TESTEFT0001234~
```
| Element | Name | Example | What it means |
|---|---|---|---|
| **STC01-1** | Claim Status Category Code | `F1` | Finalized/Payment: the claim/line has been paid |
| **STC01-2** | Claim Status Code | `65` | Claim/line has been paid |
| **STC01-3** | Entity Identifier Code | | Which party the status refers to, when the code requires one |
| **STC02** | Status Information Effective Date | `20261104` | When this status took effect |
| **STC03** | Action Code | | Used on the 277CA (accept or reject) |
| **STC04** | Total Claim Charge Amount | `285` | The billed amount |
| **STC05** | Claim Payment Amount | `198.4` | What the payer paid |
| **STC06** | Adjudication or Payment Date | `20261104` | When it was adjudicated or paid |
| **STC07** | Payment Method Code | `ACH` | For example `ACH` or `CHK` |
| **STC08** | Check Issue or EFT Effective Date | `20261106` | When the money moves |
| **STC09** | Check or EFT Trace Number | `TESTEFT0001234` | Matches the trace number on the 835 and the bank deposit |
| **STC10 / STC11** | Additional status composites | | More category/status pairs for the same claim |
| **STC12** | Free-form Message Text | | Payer text |
`STC01` is a composite, separated by the component separator from `ISA16` (`:` in this sample). Read the category and the status code together. `F2:88:QC` in the X12 example means finalized/denial, "entity not eligible for benefits for submitted dates of service," and the entity is the patient (`QC`).
### Claim Status Category Codes
| Code | Meaning (X12) | What to do |
|---|---|---|
| `A1` | Acknowledgement/Receipt | Claim received; wait |
| `A2` | Acknowledgement/Acceptance into adjudication system | Claim is in processing; wait |
| `A3` | Acknowledgement/Returned as unprocessable claim | Correct and resubmit |
| `A4` | Acknowledgement/Not Found | Check identifiers, the 999 and the 277CA; the claim may never have arrived |
| `A6` / `A7` | Rejected for missing / invalid information | Fix what the status code names and resubmit |
| `E0` | Response not possible: error on submitted request data | Fix the 276 itself |
| `F1` | Finalized/Payment | Watch for the 835 and the deposit |
| `F2` | Finalized/Denial | Review the denial; the 835 carries adjustment reason codes |
| `F3` | Finalized/Revised | Adjudication changed; reconcile against the earlier 835 |
| `F4` | Finalized/Adjudication complete, no payment forthcoming | No payment is coming from this payer; the 835 shows why |
| `P1` | Pending/In Process | Wait |
| `P2` | Pending/Payer Review | Wait, or be ready for a records request |
| `P3` / `P4` | Pending/Provider or Patient Requested Information | The payer is waiting on someone; find out what it needs |
| `R0`, `R1`, `R3`-`R17` | Requests for additional information | Respond with what is requested |
### Claim Status Codes You Will See Often
| Code | Meaning (X12) |
|---|---|
| `1` | For more detailed information, see remittance advice |
| `3` | Claim has been adjudicated and is awaiting payment cycle |
| `20` | Accepted for processing |
| `21` | Missing or invalid information (always paired with another code naming the item) |
| `33` | Subscriber and subscriber id not found |
| `35` | Claim/encounter not found |
| `46` | Internal review/audit |
| `65` | Claim/line has been paid |
| `88` | Entity not eligible for benefits for submitted dates of service |
| `187` | Date(s) of service |
There are hundreds of status codes, and X12 adds, changes and retires them on its maintenance cycle. Load the current list from X12 rather than freezing a table in your code.
### REF: The Payer's Claim Number
```
REF*1K*TESTPCN0000001~
REF*EJ*SMPCLM1001~
```
`REF*1K` is the payer's claim control number. Save it on the claim: it is the best key for future 276s, appeals, corrected claims and phone calls. `REF*EJ` echoes your patient control number.
### SVC: Line-Level Status
```
SVC*HC:99203*150*0****1~
STC*F2:88:QC*20050612~
```
When a payer reports status by line, each 2220 loop starts with `SVC` (procedure composite, line charge, line payment) and carries its own `STC`. The X12 example above shows a line that was billed at $150, paid $0, and denied with the same reason as the claim.
## Where the 277 Sits in the Claim Cycle
1. Provider sends the [837 claim](/guides/edi/837-health-care-claim).
2. Clearinghouse or payer returns a 999 for the file and a 277CA for each claim.
3. Provider sends a 276 for claims still open after the expected window.
4. Payer returns the **277** with `STC` status for each claim.
5. Payer sends the [835](/guides/edi/835-health-care-claim-payment-advice) with payment and adjustment detail for finalized claims.
Eligibility problems that show up as `F2` denials, such as status code `88`, are cheaper to catch earlier with a [270](/guides/edi/270-eligibility-benefit-inquiry) and [271](/guides/edi/271-eligibility-benefit-response), and services that need authorization go through the [278](/guides/edi/278-health-care-services-review) before the visit.
## Common 277 Errors and How to Prevent Them
| Error | What happens | Prevention |
|---|---|---|
| **Only `STC01-1` read** | `F2` treated the same regardless of reason | Store and route on category plus status code plus entity |
| **`STC10` and `STC11` ignored** | Missed second and third statuses | Parse every status composite in every `STC` |
| **Line-level `STC` ignored** | Partial denials missed | Process 2220 loops when present |
| **Payer claim number not saved** | Harder follow-up, duplicate claims | Store `REF*1K` on the claim record |
| **"Not found" answered by resubmitting immediately** | Duplicate claims | Check the 277CA and 999 history first |
| **277CA rejections left in a queue** | Claim never enters adjudication; filing limits run | Work `A3`, `A6` and `A7` acknowledgments daily |
| **Hard-coded status code table** | New codes show as unknown | Refresh the X12 code lists on each maintenance release |
| **277 payment amount used to post cash** | Posting without adjustment detail | Post from the 835; use the 277 for status and follow-up |
## 277 Implementation Checklist
- Accept `GS01` = `HN` groups with `005010X212` and, if you receive them, `005010X214` for 277CAs
- Route 277 and 277CA to different queues: status follow-up versus intake rejections
- Parse `STC01`, `STC10` and `STC11` composites at claim and line level
- Match on `TRN02`, and store `REF*1K`
- Load current claim status category and status codes from X12
- Map each category to a work queue: wait, fix and resubmit, send records, appeal, post
- Keep the raw 277 with the claim for audit
- Test finalized-paid, finalized-denied, pending, not-found and 277CA reject scenarios
For an introduction to X12 structure, see our [essential guide to EDI](/blog/essential-guide-to-edi), and for the other transaction sets, the [EDI document types reference](/edi-document-types).
## Where OrderSync Fits
OrderSync's product is built for supplier order flows: it reads inbound purchase orders in any format (EDI 850 and 875, PDF, email, spreadsheets), matches customers, items and units, and outputs ERP data or valid X12.
For healthcare EDI teams, the useful piece is the [free EDI inspector](/edi-inspector), which parses any X12 file, 277s and 277CAs included. Paste a test file to see each claim's `STC` status explained in plain English, segment by segment. Follow your organization's policies on protected health information before pasting a production file; test files with fictional data work just as well for checking structure.
## Frequently Asked Questions
### What is an EDI 277?
The EDI 277 is the X12 Health Care Claim Status Response. A health plan sends it in reply to a 276 request, reporting the status of each claim with STC codes and, for finalized claims, charge and payment details.
### What is a 277CA?
The 277CA is the Health Care Claim Acknowledgment, an X12 277 built to the 005010X214 implementation guide. A clearinghouse or payer sends it after receiving an 837 to say whether each claim was accepted into processing or rejected at intake.
### What is the difference between a 277 and a 277CA?
The 277 answers a 276 status request about claims already in the system. The 277CA is sent automatically after an 837 and reports whether each claim got into the adjudication system at all. They use different implementation guides, X212 and X214.
### What does STC*F1:65 mean?
F1 is the claim status category Finalized/Payment, and 65 is the status code "Claim/line has been paid." Together they say the claim has been paid. The 835 remittance gives the detail.
### What does category A4 mean in a 277?
A4 is Acknowledgement/Not Found: the payer cannot find the claim in its adjudication system. Check that the claim was accepted on the 999 and 277CA, and that the 276 used the same member, provider, charge and dates as the claim.
### Where do claim status codes come from?
X12 maintains them as external code lists: Claim Status Category Codes and Claim Status Codes. They are updated regularly, so check the current lists on x12.org rather than relying on an old copy.
### Should I post payments from a 277?
Payment posting normally comes from the 835 remittance, which carries adjustment reason codes and line-level detail. The 277's payment amount and EFT trace number help you know a payment is coming and match it later.