WIpop 837 Companion Guide and Technical Specifications

All Wisconsin licensed, Medicare-certified, hospitals, including psychiatric hospitals, and freestanding ambulatory surgery centers (FASC) are required to report inpatient and outpatient discharge data on a quarterly basis to the Wisconsin Hospital Association Information Center (WHAIC). WHAIC collects data pursuant to Chapter 153 of the State Statutes and subject to all terms and conditions as described in ss. DHS 120.

The WHAIC 837 claims file format draws from the specification for the ANSI 837 health care claim format from the American National Standards Institutes (ANSI), Accredited Standards Committee X12, National Electronic Data Interchange Transaction Set Implementation Guide, Health Care Claim: For more information: http://store.x12.org/store/healthcare-5010-original-guides OR http://www.wpc-edi.com/.

  • 837 Institutional Health Care Claim - ASC X12N 837 (005010X223A2)
  • 837 Professional Health Care Claim - ASC X12N 837 (005010X222A1)
  • 837 Reporting Health Care Claim - ASC X12N 837 (005010X225A2)

Hospitals and FASC, herein referred to as (“facilities”) are required to use a modified 837 claims file format as outlined in this Companion Guide and Technical Specification manual, see Section 5.3. The WHAIC Companion and Technical Specification Guide follows the national ANSI 837 standards and provides specifications for the submission of inpatient and outpatient hospital data, including FASC data, to the WHAIC. Only the sections required by the State of Wisconsin Statutory Requirements as defined in Chapter 153, and collected by WHAIC or situational ANSI 837 Institutional and Professional Guide sections are reproduced in this manual. Failure to comply with the requirements outlined in the Statutes, or submission deadlines as referenced in this Companion Guide, may result in a non-compliance letter to the Wisconsin Department of Administration and may include significant penalties and forfeitures.  For further information, please contact WHAIC at whainfocenter@wha.org.

  1. Introduction
  2. WHAIC Data Collection
  3. WIpop Access and Data Submission
  4. 837 Data Submission and Technical Requirements
  5. WIpop Mapping Rules and 837 File Specifications
  6. Batch Details, Validation and Affirmation Process
  7. Appendices
    1. Facility List
    2. Race & Ethnicity
    3. Expected Source of Payment and 837 Payer Mapping
    4. Type of Bill
    5. Place of Service
    6. Coding Guidelines
    7. Point of Origin for Admission or Visit
    8. Patient Discharge Status
    9. WIpop Edit Codes and Descriptions
    10. WIpop Roles and Registration
    11. De-identification of Name to Create UCID / ECID
      • Black Box Program and Instructions | DOWNLOAD
    12. Data Dictionary
    13. Manual Data Entry Instructions
    14. Marital Status Codes
    15. Terms, Acronyms and Definitions
    16. FAQ

 * 2017 WHAIC 837 Training PowerPoint | Download

 * Provider-Based Location FAQ

 * WIpop Roles Document 

* FAQs: Electronic Data Affirmation & Data Deliverables

DOWNLOAD the entire manual.

Additional ICD-10 Links

WHAIC 837 File Submission & Testing Instructions

WHA Information Center requires all facilities to successfully complete testing prior to advancing to the 837 data submission in production.  Each facility must adhere to the technical specifications in the WHAIC 837 Companion Guide and produce a HIPAA compliant 837 transaction file.  Testing is based on individual locations and facility ID, not hospital / ASC affiliation or number of facilities in a hospital system.

Previous 837 Project Announcements

Previous 837 documentation will be archived on this page as WHA Information Center continues to provide new information to the data submitters.

Historical WIpop Manual (ICD-10)

Included is the WIpop Manual (ICD-10) for historical purposes.