Segment
X12 EDI Release 00601
To specify the claim service detail for anesthesia
Elements
  • SV601C003Composite Medical Procedure IdentifierM必须(Mandatory)
    23523413391339133913393522341339133913391339
    • SV60101235Product/Service ID Qualifier
      ID
      M必须(Mandatory)

      Code identifying the type/source of the descriptive number used in Product/Service ID (234)

      Codes (518)
    • SV60102234Product/Service ID
      AN
      M必须(Mandatory)
      Min 0 / Max 80

      Identifying number for a product or service

    • SV601031339Procedure Modifier
      AN
      O可选(Optional)
      Min 2 / Max 2

      This identifies special circumstances related to the performance of the service, as defined by trading partners

    • SV601041339Procedure Modifier
      AN
      O可选(Optional)
      Min 2 / Max 2

      This identifies special circumstances related to the performance of the service, as defined by trading partners

    • SV601051339Procedure Modifier
      AN
      O可选(Optional)
      Min 2 / Max 2

      This identifies special circumstances related to the performance of the service, as defined by trading partners

    • SV601061339Procedure Modifier
      AN
      O可选(Optional)
      Min 2 / Max 2

      This identifies special circumstances related to the performance of the service, as defined by trading partners

    • SV60107352Description
      AN
      O可选(Optional)
      Min 1 / Max 80

      A free-form description to clarify the related data elements and their content

    • SV60108234Product/Service ID
      AN
      O可选(Optional)
      Min 1 / Max 80

      Identifying number for a product or service

    • SV601091339Procedure Modifier
      AN
      O可选(Optional)
      Min 2 / Max 2

      This identifies special circumstances related to the performance of the service, as defined by trading partners

    • SV601101339Procedure Modifier
      AN
      O可选(Optional)
      Min 2 / Max 2

      This identifies special circumstances related to the performance of the service, as defined by trading partners

    • SV601111339Procedure Modifier
      AN
      O可选(Optional)
      Min 2 / Max 2

      This identifies special circumstances related to the performance of the service, as defined by trading partners

    • SV601121339Procedure Modifier
      AN
      O可选(Optional)
      Min 2 / Max 2

      This identifies special circumstances related to the performance of the service, as defined by trading partners

  • SV6021332Facility Code Qualifier
    ID
    O可选(Optional)

    Code identifying the type of facility referenced

    Codes (2)
  • SV6031331Facility Code Value
    AN
    O可选(Optional)
    Min 1 / Max 3

    Code identifying where services were, or may be, performed; the National Uniform Billing Committee (NUBC) Facility Type Code for Institutional Services or the Place of Service Codes for Professional or Dental Services.

  • SV604782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • SV6051328Diagnosis Code Pointer
    N
    O可选(Optional)
    Min 1 / Max 2

    A pointer to the diagnosis code in the order of importance to this service

  • SV606380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • SV6071073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response

    Codes (4)