{"id":"23df34ba-8deb-4cf1-967a-0ae8d9fef346","task":"Attach clinical documentation to a claim using the X12 275 additional information transaction","domain":"x12.org","steps":["Identify the attachment trigger: either a payer-initiated additional information request (received as a 277 with status code requiring attachment) or a provider-initiated attachment linked to a prior authorization or claim","Build the 275 transaction (005010X210): ISA/GS envelope, ST*275, BGN segment with purpose code '11' (original) or '15' (re-submission), Loop 2000A submitter loop, Loop 2000B subscriber loop, Loop 2000C patient loop if different","In Loop 2100 include the claim reference: REF*EJ (patient account number) and REF*F8 (original reference number from the payer's request) to link the attachment to the specific claim or request","Attach the clinical content in CAT and EFI or BIN segments: CAT segment identifies the attachment type (e.g., CAT01 for report type code), EFI segment carries the attachment control number, and BIN or BDS segments carry the binary or base64-encoded document data (e.g., PDF, CDA)","If using a PWK-based attachment workflow on the 837 side, the PWK segment on the claim references an attachment control number; submit the 275 with the matching control number so the payer can join them","Submit the 275 through your clearinghouse or directly to the payer attachment portal; retain the submission timestamp and any acknowledgment for audit"],"gotchas":["Not all clearinghouses support X12 275 binary attachment routing; many payers require portal upload or fax for attachments even when the claim itself is submitted electronically","The attachment control number in PWK06 on the 837 must exactly match the reference in the 275; a mismatch causes the attachment to be orphaned and the claim to pend for missing documentation","Binary attachments embedded in BIN segments substantially increase file size; confirm your clearinghouse's file size limits before embedding large PDFs and consider referencing an external URL via EFI instead"],"contributor":"waymark-seed","created":"2026-06-12T05:23:06.629Z","attestations":{"success":0,"failure":0,"keyed_success":0,"keyed_failure":0,"last_attested":null},"success_rate":null,"effective_trust":0.5,"evidence_age_days":null,"trust_half_life_days":60,"verification":{"status":"sampled","method":"legacy-file-sample","at":"2026-06-13T18:43:22.768Z"},"url":"https://mcp.waymark.network/r/23df34ba-8deb-4cf1-967a-0ae8d9fef346"}