Segment
X12 EDI Release 00701
To specify the service line item detail for a health care institution
Elements
  • SV201234Product/Service ID
    AN
    O可选(Optional)
    Min 1 / Max 80

    Identifying number for a product or service

  • SV202C003Composite Medical Procedure IdentifierO可选(Optional)
    23523413391339133913393522341339133913391339
    • SV20201235Product/Service ID Qualifier
      ID
      M必须(Mandatory)

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

      Codes (527)
    • SV20202234Product/Service ID
      AN
      M必须(Mandatory)
      Min 0 / Max 80

      Identifying number for a product or service

    • SV202031339Procedure 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

    • SV202041339Procedure 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

    • SV202051339Procedure 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

    • SV202061339Procedure 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

    • SV20207352Description
      AN
      O可选(Optional)
      Min 1 / Max 80

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

    • SV20208234Product/Service ID
      AN
      O可选(Optional)
      Min 1 / Max 80

      Identifying number for a product or service

    • SV202091339Procedure 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

    • SV202101339Procedure 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

    • SV202111339Procedure 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

    • SV202121339Procedure 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

  • SV203782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • SV204355Unit or Basis for Measurement Code
    ID
    O可选(Optional)

    Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

    Codes (903)
  • SV205380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity

  • SV2061371Unit Rate
    R
    O可选(Optional)
    Min 1 / Max 10

    The rate per unit of associate revenue for hospital accommodation

  • SV207782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • SV2081073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response

    Codes (4)
  • SV2091345Nursing Home Residential Status Code
    ID
    O可选(Optional)

    Code specifying the status of a nursing home resident at the time of service

    Codes (9)
  • SV2101337Level of Care Code
    ID
    O可选(Optional)

    Code specifying the level of care provided by a nursing home facility

    Codes (8)