132: National Uniform Billing Committee (NUBC) Codes
HI01-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI01-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI01-04 1251 Date Time Period X AN 1/35 Required 1
HI02 C022 Health Care Code Information O Comp Situational 1
Situational Rule: Required when it is necessary to report an additional occurrence code and the preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI02-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI02-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI02-04 1251 Date Time Period X AN 1/35 Required 1
HI03 C022 Health Care Code Information O Comp Situational 1
5010X837IA2.ecs 103 For internal use only Situational Rule: Required when it is necessary to report an additional occurrence code and the
preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI03-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI03-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI03-04 1251 Date Time Period X AN 1/35 Required 1
HI04 C022 Health Care Code Information O Comp Situational 1
Situational Rule: Required when it is necessary to report an additional occurrence code and the preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI04-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI04-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI04-04 1251 Date Time Period X AN 1/35 Required 1
HI05 C022 Health Care Code Information O Comp Situational 1 Situational Rule: Required when it is necessary to report an additional occurrence code and the
preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
HI05-01 1270 Code List Qualifier Code M ID 1/3 Required 1
BH Occurrence CODE SOURCE:
132: National Uniform Billing Committee (NUBC) Codes
HI05-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI05-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI05-04 1251 Date Time Period X AN 1/35 Required 1
HI06 C022 Health Care Code Information O Comp Situational 1
Situational Rule: Required when it is necessary to report an additional occurrence code and the preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI06-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI06-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI06-04 1251 Date Time Period X AN 1/35 Required 1
HI07 C022 Health Care Code Information O Comp Situational 1 Situational Rule: Required when it is necessary to report an additional occurrence code and the
preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI07-02 1271 Industry Code M AN 1/30 Required 1
5010X837IA2.ecs 105 For internal use only
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI07-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI07-04 1251 Date Time Period X AN 1/35 Required 1
HI08 C022 Health Care Code Information O Comp Situational 1
Situational Rule: Required when it is necessary to report an additional occurrence code and the preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI08-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI08-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI08-04 1251 Date Time Period X AN 1/35 Required 1
HI09 C022 Health Care Code Information O Comp Situational 1
Situational Rule: Required when it is necessary to report an additional occurrence code and the preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI09-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI09-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
D8 Date Expressed in Format CCYYMMDD
HI09-04 1251 Date Time Period X AN 1/35 Required 1
HI10 C022 Health Care Code Information O Comp Situational 1 Situational Rule: Required when it is necessary to report an additional occurrence code and the
preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI10-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI10-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI10-04 1251 Date Time Period X AN 1/35 Required 1
HI11 C022 Health Care Code Information O Comp Situational 1
Situational Rule: Required when it is necessary to report an additional occurrence code and the preceding HI data elements have been used to report other occurrence codes. If not required by this implementation guide, do not send.
132: National Uniform Billing Committee (NUBC) Codes
HI11-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI11-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI11-04 1251 Date Time Period X AN 1/35 Required 1
HI12 C022 Health Care Code Information O Comp Situational 1
Situational Rule: Required when it is necessary to report an additional occurrence code and the preceding HI data elements have been used to report other occurrence codes. If not required by this
5010X837IA2.ecs 107 For internal use only implementation guide, do not send.
HI12-01 1270 Code List Qualifier Code M ID 1/3 Required 1
Code Name
BH Occurrence
CODE SOURCE:
132: National Uniform Billing Committee (NUBC) Codes
HI12-02 1271 Industry Code M AN 1/30 Required 1
ExternalCodeList
Name: 132
Description: National Uniform Billing Committee (NUBC) Codes
HI12-03 1250 Date Time Period Format Qualifier X ID 2/3 Required 1
Code Name
D8 Date Expressed in Format CCYYMMDD
HI12-04 1251 Date Time Period X AN 1/35 Required 1
Situational Rule:
Required when there is a Occurrence Code that applies to this claim. If not required by this implementation guide, do not send.
TR3 Example:
HI*BH:42:D8:20051208*BH:A3:D8:20051203~