3.0 EDI Edit Matrix


Edits applied by a jurisdiction must be identified on the Jurisdiction’s Edit Matrix to assist the sender in understanding the edits that will be applied and the data quality expected by the jurisdiction. The edits that are applied by the jurisdiction should be based on the IAIABC standards and on the jurisdiction’s data requirements that were in place on the date of the accident, or the effective date of a statute or rule change and based on the requirements that are indicated on the Jurisdiction Data Element Requirement Table. As such, it may be updated periodically to reflect any changes.

The Matrix consists of 5 components:

  1. DN-Error Message contains “standard” editing developed for R3 data elements.
  2. Value Table expresses the jurisdiction’s acceptable code values
  3. Match Data describes the data elements that will be used determine if the report will create a new claim or find an existing claim or transaction in the jurisdiction’s database.
  4. Population Restrictions contains the jurisdiction’s restrictions applied to the data element(s).
  5. 063 Sequence Editing illustrates logical transaction sequencing for application of edit 063.

The Matrix design conveys to the sender the edits that the jurisdiction will apply to each data element and the edits that will be applied based on population of the data element in the transaction. Editing results determine the outcome for processing the data into their system and communicate the results that will be returned in the Acknowledgment Record for each specific transaction. Note: The receiver of the acknowledgment, where error(s) are indicated, should evaluate the error(s) and consider revisions to their system edits for data reporting for the specific data element. This will assist in improved data quality and reporting compliance not only for that specific transaction but also for future transactions where the specific data element(s) are sent.

(source: IAIABC IG)