Levels of Testing
segment order, element attributes, testing for numeric values in numeric data elements,
validation of X12 syntax and compliance with X12 rules."
2. Requirement Testing : Testing for HIPAA implementation-guide-specific requirements, such as repeat counts, used and not used codes, elements and segments, required or intra-segment situational data elements- non-medical code sets as laid out in the implementation guide - and values noted in the implementation guide via an X12 code list or table.
3. Balancing Testing : Testing the transaction for balanced field totals, record or segment counts, financial
balancing of claims or remittance advice, and balancing of summary fields.
4. Situation Testing : Testing of specific inter-segment situations described in the HIPAA implementation
guides such that: If A occurs then B must be populated. This is considered to include the validation of situational fields given values or situations present elsewhere in the file. A typical situation testing: there is a dependent loop but no subscriber loop in a transaction.
5. Code Set Testing : Testing for valid implementation-guide-specific code set values.
6. Line-of-Business Testing : Specialized testing required by certain healthcare specialties. For example Hospice Care, Home Oxygen Treatment, and Ambulance Service all have unique data requirements when submitting health care claims to a payor.