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HI Value Information Pos: 2310 Detail - Optional Max: 2 Loop: 2300 Elements: 12

In document 837 Health Care Claim : Institutional (Page 112-117)

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

HI01-05 782 Monetary Amount O R 1/18 Required 1

HI02 C022 Health Care Code Information O Comp Situational 1

Situational Rule: Required when it is necessary to report an additional value code and the preceding HI data elements have been used to report other value 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

HI02-05 782 Monetary Amount O R 1/18 Required 1

HI03 C022 Health Care Code Information O Comp Situational 1

Situational Rule: Required when it is necessary to report an additional value code and the preceding HI data elements have been used to report other value codes. If not required by this implementation guide, do not send.

132: National Uniform Billing Committee (NUBC) Codes

5010X837IA2.ecs 109 For internal use only HI03-02 1271 Industry Code M AN 1/30 Required 1

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

HI03-05 782 Monetary Amount O R 1/18 Required 1

HI04 C022 Health Care Code Information O Comp Situational 1

Situational Rule: Required when it is necessary to report an additional value code and the preceding HI data elements have been used to report other value 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

HI04-05 782 Monetary Amount O R 1/18 Required 1

HI05 C022 Health Care Code Information O Comp Situational 1 Situational Rule: Required when it is necessary to report an additional value code and the preceding HI

data elements have been used to report other value codes. If not required by this implementation guide, do not send.

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

HI05-05 782 Monetary Amount O R 1/18 Required 1

HI06 C022 Health Care Code Information O Comp Situational 1

Situational Rule: Required when it is necessary to report an additional value code and the preceding HI data elements have been used to report other value codes. If not required by this implementation guide, do not send.

HI06-02 1271 Industry Code M AN 1/30 Required 1

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

HI06-05 782 Monetary Amount O R 1/18 Required 1

HI07 C022 Health Care Code Information O Comp Situational 1 Situational Rule: Required when it is necessary to report an additional value code and the preceding HI

data elements have been used to report other value 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

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

HI07-05 782 Monetary Amount O R 1/18 Required 1

HI08 C022 Health Care Code Information O Comp Situational 1

Situational Rule: Required when it is necessary to report an additional value code and the preceding HI data elements have been used to report other value 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

HI08-05 782 Monetary Amount O R 1/18 Required 1

HI09 C022 Health Care Code Information O Comp Situational 1

Situational Rule: Required when it is necessary to report an additional value code and the preceding HI data elements have been used to report other value codes. If not required by this implementation guide, do not send.

5010X837IA2.ecs 111 For internal use only CODE SOURCE:

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

HI09-05 782 Monetary Amount O R 1/18 Required 1

HI10 C022 Health Care Code Information O Comp Situational 1 Situational Rule: Required when it is necessary to report an additional value code and the preceding HI

data elements have been used to report other value 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

HI10-05 782 Monetary Amount O R 1/18 Required 1

HI11 C022 Health Care Code Information O Comp Situational 1

Situational Rule: Required when it is necessary to report an additional value code and the preceding HI data elements have been used to report other value 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

HI11-05 782 Monetary Amount O R 1/18 Required 1

HI12 C022 Health Care Code Information O Comp Situational 1 Situational Rule: Required when it is necessary to report an additional value code and the preceding HI

data elements have been used to report other value codes. If not required by this implementation guide, do not send.

HI12-01 1270 Code List Qualifier Code M ID 1/3 Required 1

BE Value 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

HI12-05 782 Monetary Amount O R 1/18 Required 1

Situational Rule:

Required when there is a Value Code that applies to this claim. If not required by this implementation guide, do not send.

TR3 Example:

HI*BE:08::1740*BE:A7::940~

5010X837IA2.ecs 113 For internal use only

HI Treatment Code Information

Pos: 2310 Detail - Optional Max: 2

In document 837 Health Care Claim : Institutional (Page 112-117)