ediverse

Type to search across standards, messages, tools and glossary.

ediverse Explore the platform

Spotlight PEPPOL BIS Billing 3.0 The EU e-invoicing mandate is here — France Sept 2026, Belgium Jan 2026, Germany 2025.

— 01

Foundations

— 02

Standards

— 03

Flagship messages

— 04

Tools

X12 275 — Patient Information

The 275 transmits detailed patient information — demographic, clinical, supporting documents — to back up an 837 claim or respond to a payer's request for additional information.

Purpose

The 275 answers a recurring need in the HIPAA flow: a payer receives an 837 (claim) and needs additional information to adjudicate — a copy of an operative note, lab results, authorization form, attestation. The provider transmits these pieces via a 275, encapsulating documents as binary attachments (PDF, image, text) or as structured elements depending on the type of information required.

The 275 comes in two main flavors under 5010: X210 (Additional Information to Support a Health Care Claim) and X211 (Patient Information / Encounter). In production, X210 is the most encountered because it handles responses to a 277CA / 277 Request for Additional Information.

Envelope structure

The 275 travels in a functional group PI (Patient Information). The GS08 carries the release + Implementation Guide: 005010X210. Didactic example for an additional-information response:

x12 example-275.x12 
ISA*00*          *00*          *ZZ*ACMEPROVIDER  *ZZ*ACMEPAYER     *260514*1300*U*00501*000000275*0*P*>~
GS*PI*ACMEPROVIDER*ACMEPAYER*20260514*1300*1*X*005010X210~
ST*275*0001*005010X210~
BGN*02*PAT-INFO-2026-001*20260514*1300****NO~
NM1*PR*2*ACME PAYER PLAN****PI*ACMEPAYER~
NM1*1P*2*ACME CLINIC****XX*1234567890~
NM1*QC*1*DOE*JANE****MI*MEMBER-001~
DTP*472*D8*20260420~
LX*1~
TRN*1*CLM-2026-555*1234567890~
STC*A1:21**WQ~
SE*9*0001*005010X210~
GE*1*1~
IEA*1*000000275~

The BGN opens the transaction. The NM1 segments identify the payer (PR), provider (1P), and patient / member (QC). The DTP states the service date. The LX loop and TRN bind the response to the original claim; STC codes the nature of the information transmitted. Binary attachments (PDF, image) are encapsulated via BDS/BIN.

Common segments

  • Header — ST, BGN (Beginning Segment).
  • Parties — NM1 loop (PR = Payer, 1P = Provider, QC = Patient).
  • Dates — DTP (service date, response date).
  • Claim link — LX loop with TRN (Trace Number) claim reference, STC (Status Information).
  • Body — NTE (free text) or BDS/BIN for binary attachments (PDF, image).
  • Summary — SE.

Common pitfalls

  • Trace Number: TRN must echo the original claim number exactly (and the 277 request number when relevant), or the payer cannot reattach the response.
  • Base64 binary: BDS/BIN segments encapsulate binaries in base64 with MIME; honor per-segment size caps (often 80 KB) and chain when needed.
  • X210 vs X211: don't confuse them: X210 supports a claim, X211 proactively transmits an encounter. GS08 must exactly reflect the variant.

Documentation

The code 275 and the name Patient Information are public and listed on x12.org/products/transaction-sets. The X210 and X211 Implementation Guides are distributed by WPC EDI (wpc-edi.com) under license and referenced by HIPAA.