Module: Stupidedi::Versions::FiftyTen::ElementDefs
- Defined in:
- lib/stupidedi/versions/005010/element_defs.rb
Constant Summary collapse
- E2 =
t::Nn.new(:E2 , "Number of Accepted Transaction Sets" , 1, 6, 0)
- E19 =
t::AN.new(:E19 , "City Name" , 2, 30)
- E26 =
t::ID.new(:E26 , "Country Code" , 2, 3, s::CodeList.external("5"))
- E28 =
t::Nn.new(:E28 , "Group Control Number" , 1, 9, 0)
- E61 =
t::AN.new(:E61 , "Free-form Information" , 1, 30)
- E65 =
t:: R.new(:E65 , "Height" , 1, 8)
- E66 =
t::ID.new(:E66 , "Identification Code Qualifier" , 1, 2, s::CodeList.build( "1" => s::CodeList.external("16"), "9" => s::CodeList.external("16"), "21" => s::CodeList.external("121"), "24" => "Employer’s Identification Number", "34" => "Social Security Number", "38" => s::CodeList.external("5"), "46" => "Electronic Transmitter Identification Number (ETIN)", "51" => s::CodeList.external("51"), "58" => "@todo", "94" => "Code assigned by the organization that is the ultimate destination of the transaction set", "AC" => "Attachment Control Number", "AD" => "Blue Cross Blue Shield Associtation Plan Code", "BD" => "Blue Cross Provider Number", "BS" => "Blue Shield Provider Number", "C" => "Insured's Changed Unique Identification Number", "C1" => "@todo", "CF" => s::CodeList.external("91"), "CI" => "@todo", "EI" => "@todo", "FA" => "Facility Identification", "FI" => "Federal Taxpayer's Identification Number", "HN" => "Health Insurance Claim (HIC) Number", "II" => "Standard Unique Health Identifier for each Individual in the United States", "LD" => s::CodeList.external("457"), "LE" => s::CodeList.external("102"), "NI" => "National Association of Insurance Commisioners (NAIC) Identification", "MI" => "Member Identification Number", "MC" => "Medicaid Provider", "MR" => "Medicaid Recipient Identification Number", "PC" => "Provider Commercial Number", "PI" => "Payor Identification", "PP" => "Pharmacy Processor Number", "SJ" => s::CodeList.external("22"), "SL" => "State License Number", "SV" => "Service Provider Number", "UP" => "Unique Physician Identification Number (UPIN)", "XV" => s::CodeList.external("540"), "XX" => s::CodeList.external("537"), "ZZ" => "Mutually Defined"))
- E67 =
t::AN.new(:E67 , "Identification Code" , 2, 80)
- E81 =
t:: R.new(:E81 , "Weight" , 1, 10)
- E93 =
t::AN.new(:E93 , "Name" , 1, 60)
- E96 =
t::Nn.new(:E96 , "Number of Included Segments" , 1, 10, 0)
- E97 =
t::Nn.new(:E97 , "Number of Transaction Sets Included" , 1, 6, 0)
- E98 =
t::ID.new(:E98 , "Entity Identifier Code" , 2, 3, s::CodeList.build( "03" => "Dependent", "13" => "Contracted Service Provider", "17" => "Consultant's Office", "1E" => "Health Maintenance Organization (HMO)", "1G" => "Oncology Center", "1H" => "Kidney Dialysis Unit", "1I" => "Preferred Provider Organization (PPO)", "1O" => "Acute Care Hospital", "1P" => "Provider", "1Q" => "Military Facility", "1R" => "University, College or School", "1S" => "Outpatient Surgicenter", "1T" => "Physician, Clinic or Group Practice", "1U" => "Long Term Care Facility", "1V" => "Extended Care Facility", "1W" => "Psychiatric Health Facility", "1X" => "Laboratory", "1Y" => "Retail Pharmacy", "1Z" => "Home Health Care", "28" => "Subcontractor", "2A" => "Federal, State, County or City Facility", "2B" => "Third-Party Administrator", "2D" => "Miscellaneous Health Care Facility", "2E" => "Non-Health Care Miscellaneous Facility", "2I" => "Church Operated Facility", "2K" => "Partnership", "2J" => "Individial", "2P" => "Public Health Service Facility", "2Q" => "Veterans Aadministration Facility", "2S" => "Public Health Service Indian Service Facility", "2T" => "Department of Justice Facility", "2Y" => "General Medical and Surgical Facility", "2Z" => "Hospital Unit of an Institution (Prison Hospital, College Infirmary, etc.)", "30" => "Service Supplier", "31" => "Postal Mailing Address", "36" => "Employer", "3A" => "Hospital Unit Within an Institution for the Mentally Retarded", "3B" => "Psychiatric Facility", "3C" => "Tuberculosis and Other Respitory Diseases Facility", "3D" => "Obstetrics and Gynecology Facility", "3E" => "Ear, Eye, Nose and Throat Facility", "3F" => "Rehabilitation Facility", "3G" => "Orthopedic Facility", "3H" => "Chronic Disease Facility", "3I" => "Other Specialty Facility", "3J" => "Children's General Facility", "3K" => "Children's Hospital Unit of an Institution", "3L" => "Children's Psychiatric Facility", "3M" => "Children's Tuberculosis and Other Respitory Diseases Facility", "3N" => "Children's Eye, Ear, Nose and Throat Facility", "3O" => "Children's Rehabilitation Facility", "3P" => "Children's Othropedic Facility", "3Q" => "Children's Chronic Disease Facility", "3R" => "Children's Other Specialty Facility", "3S" => "Institution for Mental Retardation", "3T" => "Alcoholism and Other Chemical Dependency Facility", "3U" => "General Inpatient Care for AIDS/ARC Facility", "3V" => "AIDS/ARC Unit", "3W" => "Specialized Outpatient Program for AIDS/ARC", "3X" => "Alcohol/Drug Abuse or Dependency Inpatient Unit", "3Y" => "Alcohol/Drug Abuse or Dependency Outpatient Services", "3Z" => "Arthritis Treatment Center", "40" => "Receiver", "41" => "Submitter", "43" => "Claimant Authorized Representative", "44" => "Data Processing Service Bureau", "45" => "Drop-off Location", "4A" => "Birthing Room/LDRP Room", "4B" => "Burn Care Unit", "4C" => "Cardiac Catherization Labratory", "4D" => "Open-Heart Surgery Facility", "4E" => "Cardiac Intensive Car Unit", "4F" => "Angioplasty Facility", "4G" => "Chronic Obstructive Pulmonary Disease Service Facility", "4H" => "Emergency Department", "4I" => "Trauma Center (Certified)", "4J" => "Extracorporeal Shock-Wave Lithotripter (ESWL) Unit", "4K" => "Fitness Center", "4L" => "Genetic Counseling/Screening Services", "4M" => "Adult Day Care Program Facility", "4N" => "Alzheimer's Diagnostic/assessment Service", "4O" => "Comprehensive Geriatric Assessment Facility", "4P" => "Emergency Response (Geriatric) Unit", "4Q" => "Geriatric Acute Care Unit", "4R" => "Geriatric Clinics", "4S" => "Respite Care Facility", "4U" => "Patient Education Unit", "4V" => "Community Health Promotion Facility", "4W" => "Worksite Health Promotion Facility", "4X" => "Hemodialysis Facility", "4Y" => "Home Health Services", "4Z" => "Hospice", # yes, the lack of commas are in the document # yes, this makes me very sad "5A" => "Medical Surgical or Other Intensive Care Unit", "5B" => "Hisopathology Laboratory", "5C" => "Blood Bank", "5D" => "Neonatal Intensive Care Unit", "5E" => "Obstetrics Unit", "5F" => "Occupational Health Services", "5G" => "Organized Outpatient Services", "5H" => "Pediatric Acute Inpatient Unit", "5I" => "Psychiatric Child/Adolescent Services", "5J" => "Psychiatric Consultation-Liaison Services", "5K" => "Psychiatric Education Services", "5L" => "Psychiatric Emergency Services", "5M" => "Psychiatric Geriatric Services", "5N" => "Psychiatric Inpatient Unit", "5O" => "Psychiatric Outpatient Services", "5P" => "Psychiatric Partial Hospitalization Program", "5Q" => "Megavoltage Radiation Therapy Unit", "5R" => "Radioactive Implants Unit", "5S" => "Therapeutic Radioisotope Facility", "5T" => "X-Ray Radiation Therapy Unit", "5U" => "CT Scanner Unit", "5V" => "Diagnostic Radioisotope Facility", "5W" => "Magnetic Resonance Imaging (MRI) Facility", "5X" => "Ultrasound Unit", "5Y" => "Rehabilitation Inpatient Unit", "5Z" => "Rehabilitation Outpatient Services", "61" => "Performed At", "62" => "Applicant's Employer", "6A" => "Reproductive Health Services", "6B" => "Skilled Nursing or Other Long-Term Care Unit", "6C" => "Single Photon Emission Computerized Tomography (SPECT) Unit", "6D" => "Organized Social Work Service Facility", "6E" => "Outpatient Social Work Services", "6F" => "Emergency Department Social Work Services", "6G" => "Sports Medicine Clinic/Services", "6H" => "Hospital Auxiliary Unit", "6I" => "Patient Representative Services", "6J" => "Volunteer Services Department", "6K" => "Putpatient Surgery Services", "6L" => "Organ/Tissue Transplant Unit", "6M" => "Orthopedic Surgery Facility", "6N" => "Occupational Therapy Services", "6O" => "Physical Therapy Services", "6P" => "Recreational Therapy Services", "6Q" => "Respiratory Therapy Services", "6R" => "Speech Therapy Services", "6S" => "Women's Health Center/Services", "6U" => "Cardiac Rehabilitation Program Facility", "6V" => "non-Invasive Cardiac Assessment Services", "6W" => "Emergency Medical Technician", "6X" => "Disciplinary Contact", "6Y" => "Case Manager", "70" => "Prior Incorrect Insured", "71" => "Attending Physician", "72" => "Operating Physician", "73" => "Other Physician", "74" => "Corrected Insured", "75" => "Participant", "77" => "Service Location", "7C" => "Place of Occurence", "7O" => "Federally Chartered Facility", "80" => "Hospital", "82" => "Rendering Provider", "84" => "Subscriber's Employer", "85" => "Billing Provider", "87" => "Pay-to Provider", "8B" => "Primary Residence", "95" => "Research Institute", "98" => "Receiver", "9K" => "Key Person", "AG" => "Agent/Agency", "AY" => "Clearinghouse", "BO" => "Broker or Sales Office", "CK" => "Pharmacist", "CZ" => "Admitting Surgeon", "D0" => "Admitting Physician", "D2" => "Commerical Insurer", "DD" => "Assistant Surgeon", "DJ" => "Consulting Physician", "DK" => "Ordering Physician", "DN" => "Referring Provider", "DQ" => "Supervising Physician", "DO" => "Dependent Name", "DQ" => "Supervising Physician", # RESTART HERE "E1" => "Person or Other Entity Legally Responsible for a Child", "E2" => "Person or Other Entity With Whom a Child Resides", "E7" => "Previous Employer", "E9" => "Participating Laboratory", "EI" => "Executor of Estate", "EXS" => "Ex-spouse", "EY" => "@todo", "FA" => "Facility", "FD" => "Physical Address", "FE" => "Mail Address", "FS" => "Final Scheduled Destination", "G0" => "Dependent Insured", "G3" => "Clinic", "GB" => "Other Insured", "GD" => "Guardian", "GI" => "Paramedic", "GJ" => "Paramedical Company", "GK" => "Previous Insured", "GM" => "Spouse Insured", "GP" => "Gateway Provider", "GD" => "Guardian", "GW" => "Group", "GY" => "Treatment Facility", "HF" => "Healthcare Professional Shortage Area (HPSA) Facility", "HH" => "Home Health Agency", "HK" => "Subscriber", "I3" => "Independent Physicians Association (IPA)", "IJ" => "Injection Point", "IL" => "Insured or Subscriber", "IN" => "Insurer", "J6" => "Power of Attorney", "L5" => "Contact", "LI" => "Independent Lab", "LR" => "Legal Representative", "M5" => "Migrant Health Clinic", "M8" => "Educational Institution", "MR" => "Medical INsurance Carrier", "MSC" => "Mammography Screening Center", "ND" => "Next Destination", "O4" => "Factor", "OB" => "Ordered By", "OC" => "Origin Carrier", "OD" => "Doctor of Optometry", "OOP" => "Other Operating Physician", "OX" => "Oxygen Therapy Facility", "P0" => "Patient Facility", "P2" => "Primary Insured or Subscriber", "P3" => "Primary Care Provider", "P4" => "Prior Insurance Carrier", "P5" => "Plan Sponsor", "P6" => "Third Party Reviewing Preferred Provider Organization (PPO)", "P7" => "Third Party Reviewing Preferred Provider Organization (PPO)", "PE" => "Payee", "PT" => "Party to Receive Test Report", "PTP" => "Pay-to Plan Name", "PR" => "Payer", "PRP" => "Primary Payer", "PV" => "Party performing certification", "PW" => "Pickup Address", "QA" => "Pharmacy", "QB" => "Purchase Service Provider", "QC" => "Patient", "QD" => "Responsible Party", "QE" => "Policyholder", "QH" => "Physician", "QK" => "Managed Care", "QL" => "Chiropractor", "QN" => "Dentist", "QM" => "Dialysis Centers", "QO" => "Doctor of Osteopathy", "QS" => "Podiatrist", "QV" => "Group Practice", "QY" => "Medical Doctor", "R3" => "Next Scheduled Destination", "RC" => "Receiving Location", "RW" => "Rural Health Clinic", "S1" => "Parent", "S3" => "Custodial Parent", "S4" => "Skilled Nursing Facility", "SEP" => "Secondary Payer", "SJ" => "Service Provider", "SU" => "Suppplier/Manufacturer", # Used to identify the geographic location where a patient is transferred or diverted "T4" => "Transfer Point", "TL" => "Testing Laboratory", "TP" => "Primary Taxpayer", "TQ" => "Third Party Reviewing Organization (TPO)", "TT" => "Transfer To", "TTP" => "Tertiary Payer", "TU" => "Third Party Repricing Organization (TPO)", "TV" => "Third Party Administrator (TPA)", "TZ" => "Significant Other", "RM" => "@todo", "RW" => "Rural Health Clinic", "S4" => "Skilled Nursing Facility", "UH" => "Nursing Home", "VER" => "Party Performing Verification", "VN" => "Vendor", "VY" => "Organization Completing Configuration Change", "X3" => "Utilitazion Management Origanization", "X4" => "Spouse", "X5" => "Durable Medical Equipment Supplier", "Y2" => "Managed Care Organization", "ZD" => "Party to Receive Reports", "ZZ" => "Mutually Defined"))
- E100 =
t::ID.new(:E100 , "Currency Code" , 3, 3, s::CodeList.external("5"))
- E107 =
t::ID.new(:E107 , "Payment Method Type Code" , 1, 2)
- E116 =
t::ID.new(:E116 , "Postal Code" , 3, 15, s::CodeList.external("51"))
- E118 =
t:: R.new(:E118 , "Rate" , 1, 9)
- E123 =
t::Nn.new(:E123 , "Number of Received Transaction Sets" , 1, 6, 0)
- E124 =
t::AN.new(:E124 , "Application Receiver's Code" , 2, 15)
- E127 =
t::AN.new(:E127 , "Reference Identification" , 1, 50)
- E128 =
t::ID.new(:E128 , "Reference Identification Qualifier" , 2, 3, s::CodeList.build( "00" => "Contracting District Number", "01" => "American Bankers Assoc. (ABA) Transit/Routing Number (Including Check Digit, 9 Digits)", "04" => s::CodeList.external("91"), "0B" => "State License Number", "0F" => "Subscriber Number", "0N" => "@todo", "0K" => "Policy Form Identifying Number", "14" => "@todo", "17" => "Client Reporting Category", "18" => "Plan Number", "19" => "Division Identifier", "1A" => "Blue Cross Provider Number", "1B" => "Blue Shield Provider Number", "1C" => "Medicare Provider Number", "1D" => "Medicaid Provider Number", "1G" => "Provider UPIN Number", "1H" => "CHAMPUS Identification Number", "1J" => "Facility ID Number", "1K" => "Payor's Claim Number", "1L" => "Group or Policy Number", "1S" => "Ambulatory Patient Group (APG) Number", "1W" => "Member Identification Number", "23" => "Client Number", "26" => "Union Number", "28" => "Employee Identification Number", "2F" => "@todo", "2U" => "Payer Identification Number", "38" => "Master Policy Number", "3H" => "Case Number", "3L" => "Branch Identifier", "4A" => "Personal Identification Number (PIN)", "4N" => "Special Payment Reference Number", "49" => "Family Unit Number", "60" => "Account Suffix Code", "6M" => "Application Number", "6O" => "Cross Reference Number", "6P" => "Group Number", "6R" => "Provider Control Number", "82" => "Data Item Description (DID) Reference", "9A" => "Repriced Claim Reference Number", "9B" => "Repriced Line Item Reference Number", "9C" => "Adjusted Repriced Claim Reference Number", "9D" => "Adjusted Repriced Line Item Reference Number", "9F" => "Referral Number", "9K" => "Servicer", "9V" => "Payment Category", "9X" => "Account Category", "A6" => "Provider Identifier", "ABB" => "Personal ID Number", "ABY" => s::CodeList.external("540"), "ACY" => s::CodeList.external("672"), "ALS" => "Alternative List ID", "AP" => "Ambulatory Payment Classification", "APC" => s::CodeList.external("468"), "AZ" => "Health Insurance Policy Number", "BAF" => "Receipt Number", "BB" => "Authorization Number", "BLT" => "Billing Type", "BT" => "Batch Number", "CE" => "Class of Contract Code", "CLI" => "Coverage List ID", "CT" => "Contract Number", "CPT" => s::CodeList.external("133"), "D3" => s::CodeList.external("307"), "D9" => "Claim Number", "DNS" => s::CodeList.external("16"), "DP" => "Department Number", "DU" => "Dependents Information", "DUN" => s::CodeList.external("16"), "DX" => "Department/Agency Number", "E8" => "Service Contract (Coverage) Number", "E9" => "Attachment Code", "EA" => "Medical Record Identification Number", "EL" => "Electronic Device PIN Number", "EI" => "Employer's Identification Number", "EJ" => "Patient Account Number", "EO" => "Submitter Identification Number", "EV" => "Receiver Identification Number", "EW" => "Mammography Certification Number", "F2" => "Version Code - Local", "F4" => "Facility Certification Number", "F5" => "Medicare Version Code", "F6" => "Health Insurance Claim (HIC) Number", "F8" => "Original Reference Number", "FJ" => "Line Item Control Number", "FO" => "Drug Formulary Number", "FY" => "Claim Office Number", "G1" => "Prior Authorization Number", "G2" => "Provider Commercial Number", "G3" => "Predetermination of Benefits Identification Number", "G5" => "Provider Site Number", "GH" => "Identification Card Serial Number", "G4" => "Peer Review Organization (PRO) Approval Number", "GE" => "Geographic Number", "HI" => s::CodeList.external("121"), "HJ" => "Identity Card Number", "HPI" => s::CodeList.external("537"), "ICD" => s::CodeList.external("131"), "IF" => "Issue Number", "IG" => "Insurance Policy Number", "IJ" => "Standard Industry Classification (SIC) Code", "JD" => "User Identification", "LOI" => s::CodeList.external("663"), "LU" => "Location Number", "LX" => "Qualified Products List", "M7" => "Medical Assistance Category", "MRC" => s::CodeList.external("844"), "MRN" => "Mother's Medical Record Identification Number", "N5" => "Provider Plan Network Identification Number", "N6" => "Plan Network Identification Number", "N7" => "Facitily Network Identification Number", "NF" => s::CodeList.external("245"), "NQ" => "Medicaid Recipient Identification Number", "NT" => "Administrator's Reference Number", "P4" => "Project Code", "P5" => "Position Code", "PID" => "Program Identification Number", "POL" => "Policy Number", "PQ" => "Payee Indentification", "PSM" => "Credit Card Number", "PXC" => s::CodeList.external("682"), "Q4" => "Prior Identifier Number", "QQ" => "Unit Number", "RB" => "Rate code number", "SOJ" => s::CodeList.external("22"), "SY" => "Social Security Number", "T4" => "Signal Code", "TJ" => "Federal Taxpayer's Identification Number", "TV" => s::CodeList.external("224"), "VV" => "Voucher", "VY" => "Link Sequence Number", "Y4" => "Agency Claim Number", "WH" => "Master Reference (Link) Number", "X4" => "Clinical Laboratory Improvement Amendment Number", "X9" => "Internal Control Number", "XM" => "Issuer Number", "XX1" => "Special Program Code", "XX2" => "Service Area Code", "XZ" => "Pharmacy Prescription Number", "YY" => "Geographic Key", "ZH" => "Carrier Assigned Reference Number", "ZX" => "County Code", "ZZ" => "Mutually Defined"))
- E142 =
t::AN.new(:E142 , "Application's Sender Code" , 2, 15)
- E143 =
t::ID.new(:E143 , "Transaction Set Identifier Number" , 3, 3, # http://www.x12.org/x12org/docs/editransactions.pdf s::CodeList.build( # X12C Communications & Controls "102" => "Associated Data", "242" => "Data Status Tracking", "815" => "Cryptographic Service Message", "864" => "Text Message", "868" => "Electronic Form Structure", "993" => "Secured Receipt or Acknowledgment", "997" => "Functional Acknowledgment", "999" => "Implementation Acknowledgment", # X12F Finance "130" => "Student Educational Record (Transcript)", "131" => "Student Educational Record (Transcript) Acknowledgment", "132" => "Human Resource Information", "133" => "Educational Institution Record", "135" => "Student Aid Origination Record", "138" => "Education Testing and Prospect Request and Report", "139" => "Student Loan Guarantee Result", "144" => "Student Loan Transfer and Status Verification", "146" => "Request for Student Educational Record (Transcript)", "147" => "Response to Request for Student Educational Record (Transcript)", "155" => "Business Credit Report", "188" => "Educational Course Inventory", "189" => "Application for Admission to Educational Institutions", "190" => "Student Enrollment Verification", "191" => "Student Loan Pre-Claims and Claims", "197" => "Real Estate Title Evidence", "198" => "Loan Verification Information", "199" => "Real Estate Settlement Information", "200" => "Mortgage Credit Report", "201" => "Residential Loan Application", "202" => "Secondary Mortgage Market Loan Delivery", "203" => "Secondary Mortgage Market Investor Report", "205" => "Mortgage Note", "206" => "Real Estate Inspection", "245" => "Real Estate Tax Service Response", "248" => "Account Assignment/Inquiry & Service/Status", "259" => "Residential Mortgage Insurance Explanation of Benefits", "260" => "Application for Mortgage Insurance Benefits", "261" => "Real Estate Information Request", "262" => "Real Estate Information Report", "263" => "Residential Mortgage Insurance Application Response", "264" => "Mortgage Loan Default Status", "265" => "Real Estate Title Insurance Services Order", "266" => "Mortgage or Property Record Change Notification", "810" => "Invoice", "811" => "Consolidated Service Invoice/Statement", "812" => "Credit/Debit Adjustment", "814" => "General Request, Response or Confirmation", "819" => "Joint Interest Billing and Operating Expense Statement", "820" => "Payment Order/Remittance Advice", "821" => "Financial Information Reporting", "822" => "Account Analysis", "823" => "Lockbox", "824" => "Application Advice", "827" => "Financial Return Notice", "828" => "Debit Authorization", "829" => "Payment Cancellation Request", "831" => "Application Control Totals", "833" => "Mortgage Credit Report Order", "844" => "Product Transfer Account Adjustment", "849" => "Response to Product Transfer Account Adjustment", "872" => "Residential Mortgage Insurance Application", "880" => "Grocery Products Invoice", # X12G Government "103" => "Abandoned Property Filings", "105" => "Business Entity Filings", "113" => "Election Campaign & Lobbyist Reporting", "149" => "Notice of Tax Adjustment or Assessment", "150" => "Tax Rate Notification", "151" => "Electronic Filing of Tax Return Data Acknowledgment", "152" => "Statistical Government Information", "153" => "Unemployment Insurance Tax Claim or Charge Information", "154" => "Secured Interest Filing", "157" => "Notice of Power of Attorney", "158" => "Tax Jurisdiction Sourcing", "175" => "Court and Law Enforcement Notice", "176" => "Court Submission", "179" => "Environmental Compliance Reporting", "185" => "Royalty Regulatory Report", "194" => "Grant or Assistance Application", "195" => "Federal Communications Commission (FCC) License Application", "196" => "Contractor Cost Data Reporting", "249" => "Animal Toxicological Data", "251" => "Pricing Support", "280" => "Voter Registration Information", "283" => "Tax or Fee Exemption Certification", "284" => "Commercial Vehicle Safety Reports", "285" => "Commercial Vehicle Safety and Credentials Information Exchange", "286" => "Commercial Vehicle Credentials", "288" => "Wage Determination", "500" => "Medical Event Reporting", "501" => "Vendor Performance Review", "511" => "Requisition", "517" => "Material Obligation Validation", "521" => "Income or Asset Offset", "527" => "Material Due-In and Receipt", "536" => "Logistics Reassignment", "540" => "Notice of Employment Status", "561" => "Contract Abstract", "567" => "Contract Completion Status", "568" => "Contract Payment Management Report", "650" => "Maintenance Service Order", "805" => "Contract Pricing Proposal", "806" => "Project Schedule Reporting", "813" => "Electronic Filing of Tax Return Data", "826" => "Tax Information Exchange", "836" => "Procurement Notices", "838" => "Trading Partner Profile", "839" => "Project Cost Reporting", "996" => "File Transfer", # X12I Transportation "104" => "Air Shipment Information", "106" => "Motor Carrier Rate Proposal", "107" => "Request for Motor Carrier Rate Proposal", "108" => "Response to a Motor Carrier Rate Proposal", "109" => "Vessel Content Details", "110" => "Air Freight Details and Invoice", "120" => "Vehicle Shipping Order", "121" => "Vehicle Service", "125" => "Multilevel Railcar Load Details", "126" => "Vehicle Application Advice", "127" => "Vehicle Baying Order", "128" => "Dealer Information", "129" => "Vehicle Carrier Rate Update", "160" => "Transportation Automatic Equipment Identification", "161" => "Train Sheet", "163" => "Transportation Appointment Schedule Information", "204" => "Motor Carrier Load Tender", "210" => "Motor Carrier Freight Details and Invoice", "211" => "Motor Carrier Bill of Lading", "212" => "Motor Carrier Delivery Trailer Manifest", "213" => "Motor Carrier Shipment Status Inquiry", "214" => "Transportation Carrier Ship. Status Message", "215" => "Motor Carrier Pick-up Manifest", "216" => "Motor Carrier Shipment Pick-up Notification", "217" => "Motor Carrier Loading and Route Guide", "219" => "Logistics Service Request", "220" => "Logistics Service Response", "222" => "Cartage Work Assignment", "223" => "Consolidators Freight Bill and Invoice", "224" => "Motor Carrier Summary Freight Bill Manifest", "225" => "Response to a Cartage Work Assignment", "227" => "Trailer Usage Report", "228" => "Equipment Inspection Report", "240" => "Motor Carrier Package Status", "250" => "Purchase Order Shipment Management Document", "300" => "Reservation (Booking Request) (Ocean)", "301" => "Confirmation (Ocean)", "303" => "Booking Cancellation (Ocean)", "304" => "Shipping Instructions", "309" => "Customs Manifest", "310" => "Freight Receipt and Invoice (Ocean)", "311" => "Canada Customs Information", "312" => "Arrival Notice (Ocean)", "313" => "Shipment Status Inquiry (Ocean)", "315" => "Status Details (Ocean)", "317" => "Delivery/Pickup Order", "319" => "Terminal Information", "322" => "Terminal Operations and Intermodal Ramp Activity", "323" => "Vessel Schedule and Itinerary (Ocean)", "324" => "Vessel Stow Plan (Ocean)", "325" => "Consolidation of Goods in Container", "326" => "Consignment Summary List", "350" => "Customs Status Information", "352" => "U.S. Customs Carrier General Order Status", "353" => "Customs Events Advisory Details", "354" => "U.S. Customs Auto. Manifest Archive Status", "355" => "U.S. Customs Acceptance/Rejection", "356" => "U.S. Customs Permit to Transfer Request", "357" => "U.S. Customs In-Bond Information", "358" => "Customs Consist Information", "359" => "Customs Customer Profile Management", "361" => "Carrier Interchange Agreement (Ocean)", "404" => "Rail Carrier Shipment Information", "410" => "Rail Carrier Freight Details and Invoice", "412" => "Trailer or Container Repair Billing", "414" => "Rail Carhire Settlements", "417" => "Rail Carrier Waybill Interchange", "418" => "Rail Advance Interchange Consist", "419" => "Advance Car Disposition", "420" => "Car Handling Information", "421" => "Estimated Time of Arrival & Car Scheduling", "422" => "Equipment Order", "423" => "Rail Industrial Switch List", "424" => "Rail Carrier Services Settlement", "425" => "Rail Waybill Request", "426" => "Rail Revenue Waybill", "429" => "Railroad Retirement Activity", "431" => "Railroad Station Master File", "432" => "Rail Deprescription", "433" => "Railroad Reciprocal Switch File", "434" => "Railroad Mark Register Update Activity", "435" => "Standard Transportation Commodity Code Master", "436" => "Locomotive Information", "437" => "Railroad Junctions & Interchanges Activity", "440" => "Shipment Weights", "451" => "Railroad Event Report", "452" => "Railroad Problem Log Inquiry or Advice", "453" => "Railroad Service Commitment Advice", "455" => "Railroad Parameter Trace Registration", "456" => "Railroad Equipment Inquiry or Advice", "460" => "Railroad Price Distribution Request or Response", "463" => "Rail Rate Reply", "466" => "Rate Request", "468" => "Rate Docket Journal Log", "470" => "Railroad Clearance", "475" => "Rail Route File Maintenance", "485" => "Ratemaking Action", "486" => "Rate Docket Expiration", "490" => "Rate Group Definition", "492" => "Miscellaneous Rates", "494" => "Rail Scale Rates", "601" => "U.S. Customs Export Shipment Information", "603" => "Transportation Equipment Registration", "715" => "Intermodal Group Loading Plan", "854" => "Shipment Delivery Discrepancy Info.", "858" => "Shipment Information", "859" => "Freight Invoice", "920" => "Loss or Damage Claim - Gen. Commodities", "924" => "Loss or Damage Claim - Motor Vehicle", "925" => "Claim Tracer", "926" => "Claim Status Report and Tracer Reply", "928" => "Automotive Inspection Detail", "980" => "Functional Group Totals", "990" => "Response to a Load Tender", "998" => "Set Cancellation", # X12M Supply Chain "101" => "Name and Address Lists", "140" => "Product Registration", "141" => "Product Service Claim Response", "142" => "Product Service Claim", "143" => "Product Service Notification", "159" => "Motion Picture Booking Confirmation", "170" => "Revenue Receipts Statement", "180" => "Return Merchandise Authorization & Notification", "244" => "Product Source Information", "290" => "Cooperative Advertising Agreements", "503" => "Pricing History", "504" => "Clauses and Provisions", "620" => "Excavation Communication", "625" => "Well Information", "753" => "Request For Routing Instructions", "754" => "Routing Instructions", "816" => "Organizational Relationships", "818" => "Commission Sales Report", "830" => "Planning Schedule w/ Release Capability", "832" => "Price/Sales Catalog", "840" => "Request for Quotation", "841" => "Specifications/Technical Information", "842" => "Nonconformance Report", "843" => "Response to Request for Quotation", "845" => "Price Authorization Acknowledgment/Status", "846" => "Inventory Inquiry/Advice", "847" => "Material Claim", "848" => "Material Safety Data Sheet", "850" => "Purchase Order", "851" => "Asset Schedule", "852" => "Product Activity Data", "853" => "Routing and Carrier Instruction", "855" => "Purchase Order Acknowledgment", "856" => "Ship Notice/Manifest", "857" => "Shipment and Billing Notice", "860" => "Purchase Order Change Request - Buyer Initiated", "861" => "Receiving Advice/Acceptance Certificate", "862" => "Shipping Schedule", "863" => "Report of Test Results", "865" => "Purchase Order Change Acknowledgment /Request - Seller Initiated", "866" => "Production Sequence", "867" => "Product Transfer and Resale Report", "869" => "Order Status Inquiry", "870" => "Order Status Report", "873" => "Commodity Movement Services", "874" => "Commodity Movement Services Response", "875" => "Grocery Products Purchase Order", "876" => "Grocery Products Purchase Order Change", "877" => "Manufacturer Coupon Family Code Structure", "878" => "Product Authorization/De-authorization", "879" => "Price Information", "881" => "Manufacturer Coupon Redemption Detail", "882" => "Direct Store Delivery Summary Information", "883" => "Market Development Fund Allocation", "884" => "Market Development Fund Settlement", "885" => "Retail Account Characteristics", "886" => "Customer Call Reporting", "887" => "Coupon Notification", "888" => "Item Maintenance", "889" => "Promotion Announcement", "890" => "Contract & Rebate Management", "891" => "Deduction Research Report", "893" => "Item Information Request", "894" => "Delivery/Return Base Record", "895" => "Delivery/Return Acknowledgment or Adjustment", "896" => "Product Dimension Maintenance", "940" => "Warehouse Shipping Order", "943" => "Warehouse Stock Transfer Shipment Advice", "944" => "Warehouse Stock Transfer Receipt Advice", "945" => "Warehouse Shipping Advice", "947" => "Warehouse Inventory Adjustment Advice", # X12N Insurance "100" => "Insurance Plan Description", "111" => "Individual Insurance Policy & Client Info.", "112" => "Property Damage Report", "124" => "Vehicle Damage", "148" => "Report of Injury, Illness, or Incident", "186" => "Insurance Underwriting Requirements Reporting", "187" => "Premium Audit Request and Return", "252" => "Insurance Producer Administration", "255" => "Underwriting Information Services", "256" => "Periodic Compensation", "267" => "Individual Life Annuity & Disability Application", "268" => "Annuity Activity", "269" => "Health Care Benefit Coordination Verification", "270" => "Eligibility, Coverage or Benefit Inquiry", "271" => "Eligibility, Coverage or Benefit Information", "272" => "Property and Casualty Loss Notification", "273" => "Insurance/Annuity Application Status", "274" => "Health Care Provider Information", "275" => "Patient Information", "276" => "Health Care Claim Status Request", "277" => "Health Care Information Status Notification", "278" => "Health Care Services Review Information", "362" => "Cargo Insurance Advice of Shipment", "834" => "Benefit Enrollment and Maintenance", "835" => "Health Care Claim Payment/Advice", "837" => "Health Care Claim"))
- E156 =
t::ID.new(:E156 , "State or Province Code" , 2, 2, s::CodeList.external("22"))
- E166 =
t::AN.new(:E166 , "Address Information" , 1, 55)
- E212 =
t:: R.new(:E212 , "Unit Price" , 1, 17)
- E234 =
t::AN.new(:E234 , "Product/Service ID" , 1, 48)
- E235 =
t::ID.new(:E235 , "Product/Service ID Qualifier" , 2, 2, s::CodeList.build( "AD" => s::CodeList.external("135"), "A5" => s::CodeList.external("22"), "CH" => s::CodeList.external("5"), "CJ" => s::CodeList.external("135"), "DC" => s::CodeList.external("897"), "DX" => s::CodeList.external("131"), "EN" => "EAN/UCC - 13", "EO" => "EAN/UCC - 8", "ER" => s::CodeList.external("576"), "HC" => s::CodeList.external("130"), "HP" => s::CodeList.external("716"), "ID" => s::CodeList.external("131"), "IP" => s::CodeList.external("896"), "IV" => s::CodeList.external("513"), "HI" => "HIBC (Health Care Industry Bar Code) Supplier Labeling Standard Primary Data Message", "LB" => s::CodeList.external("663"), "N1" => s::CodeList.external("240"), "N2" => s::CodeList.external("240"), "N3" => s::CodeList.external("240"), "N4" => s::CodeList.external("240"), "N5" => s::CodeList.external("240"), "N6" => s::CodeList.external("240"), "NU" => s::CodeList.external("132"), "ON" => "Customer Order Number", "TD" => s::CodeList.external("359"), "UI" => "U.P.C. Consumer Package (1-5-5)", "UK" => "GTIN 14-digit Data Structure", "UP" => "UCC - 12", "RB" => s::CodeList.external("132"), "WK" => s::CodeList.external("843"), "ZZ" => "Mutually Defined"))
- E236 =
t::ID.new(:E236 , "Price Identifier Code" , 3, 3)
- E280 =
t:: R.new(:E280 , "Exchange Rate" , 4, 10)
- E289 =
t::Nn.new(:E289 , "Multiple Price Quantity" , 1, 2, 0)
- E305 =
t::ID.new(:E305 , "Transaction Handling Code" , 1, 2, s::CodeList.build( "C" => "Payment Accompanies Remittance Advice", "D" => "Make Payment Only", "H" => "Notification Only", "I" => "Remittance Information Only", "P" => "Prenotification of Future Transfers", "U" => "Split Payment and Remittance", "X" => "Handling Party's Option to Split Payment and Remittance"))
- E306 =
t::ID.new(:E306 , "Action Code" , 1, 2, s::CodeList.build( "1" => "Add", "2" => "Change (Update)", "4" => "Verify", "51" => "Complete", "71" => "Term Expired", "A1" => "Certified in Total", "A2" => "Certified - Partial", "A3" => "Not Certified", "A4" => "Pended", "A6" => "Modified", "C" => "Cancelled", "CT" => "Contact Payer", "NA" => "No Action Required", "RX" => "Replace", "U" => "Reject", "WQ" => "Accept"))
- E309 =
t::ID.new(:E309 , "Location Qualifier" , 1, 2, s::CodeList.build( "60" => "Area", "CY" => "County/Parish", "PQ" => s::CodeList.external("51"), "PR" => s::CodeList.external("51"), "PS" => s::CodeList.external("51"), "RJ" => s::CodeList.external("DOD1")))
- E310 =
t::ID.new(:E310 , "Location Identifier" , 1, 30)
- E329 =
t::AN.new(:E329 , "Transaction Set Control Number" , 4, 9)
- E332 =
t:: R.new(:E332 , "Percent, Decimal Format" , 1, 6)
- E337 =
t::TM.new(:E337 , "Time" , 4, 8)
- E338 =
t:: R.new(:E338 , "Terms Discount Percent" , 1, 6)
- E350 =
t::AN.new(:E350 , "Assigned Identification" , 1, 20)
- E352 =
t::AN.new(:E352 , "Description" , 1, 80)
- E353 =
t::ID.new(:E353 , "Transaction Set Purpose Code" , 2, 2, s::CodeList.build( "00" => "Original", "01" => "Cancellation", "06" => "Confirmation", "08" => "Status", "15" => "Re-Submission", "11" => "Response", "13" => "Request", "18" => "Reissue", "22" => "Information Copy", "49" => "Original - No Response Necessary", "52" => "Response to Historical Inquiry"))
- E355 =
t::ID.new(:E355 , "Unit or Basis for Measurement Code" , 2, 2, s::CodeList.build( "01" => "Actual Pounds", "DA" => "Days", "DH" => "Miles", "DK" => "Kilometers", "F2" => "International Unit", "GR" => "Gram", "LB" => "Pound", "ME" => "Milligram", "MJ" => "Minutes", "ML" => "Milliliter", "MO" => "Months", "UN" => "Units", "WK" => "Week", "VS" => "Visit", "YR" => "Years"))
- E363 =
t::ID.new(:E363 , "Note Reference Code" , 3, 3, s::CodeList.build( "ADD" => "Additional Information", "ALG" => "Allergies", "CER" => "Certification Narrative", "DCP" => "Goals, Rehabilitation Potential, or Discharge Plans", "DGN" => "Diagnosis Description", "DME" => "Durable Medical Equipment (DME) and Supplies", "MED" => "Medications", "NTR" => "Nutritional Requirements", "ODT" => "Orders for Disciplines and Treatments", "RHB" => "Functional Limitations, Reason Homebound, or Both", "RLH" => "Reasons Patient Leaves Home", "RNH" => "Times and Reasons Patient Not at Home", "SET" => "Unusual Home, Social Environment, or Both", "SFM" => "Safety Measures", "SPT" => "Supplementary Plan of Treatment", "TPO" => "Third Party Organization Notes", "UPI" => "Updated Information"))
- E364 =
t::AN.new(:E364 , "Communication Number" , 1, 256)
- E365 =
t::ID.new(:E365 , "Communication Number Qualifier" , 2, 2, s::CodeList.build( "AP" => "Alternate Telephone", "BN" => "Beeper Number", "CP" => "Cellular Phone", "ED" => "Electronic Data Interchange Access Number", "EM" => "Electronic Mail", "EX" => "Telephone Extension", "FX" => "Facsimile", "HP" => "Home Phone Number", "TE" => "Telephone", "UR" => "Uniform Resource Locator (URL)", "WP" => "Work Phone Number"))
- E366 =
t::ID.new(:E366 , "Contract Function Code" , 2, 2, s::CodeList.build( "1I" => "Local Contact", "AJ" => "Primary Contact", "AL" => "Alternate Contact", "BI" => "Bill Inquiry Contact", "BL" => "Technical Department", "CN" => "General Contact", "CX" => "Payers Claim Office", "EP" => "Employer Contact", "IC" => "Information Contact", "IP" => "Insured Party", "RP" => "Responsible Person", "PQ" => "Parent or Guardian", "SK" => "School Clerk"))
- E373 =
t::DT.new(:E373 , "Date" , 8, 8)
- E374 =
t::ID.new(:E374 , "Date/Time Qualifier" , 3, 3, s::CodeList.build( "007" => "Effective", "009" => "Process", "011" => "Shipped", "036" => "Expiration", "050" => "Received", "090" => "Report Start", "091" => "Report End", "096" => "Discharge", "102" => "Issue", "139" => "Estimated", "150" => "Service Period Start", "151" => "Service Period End", "152" => "Effective Date of Change", "193" => "Period Start", "194" => "Period End", "196" => "Start", "198" => "Completion", "232" => "Claim Statement Period Start", "233" => "Claim Statement Period End", "286" => "Retirement", "290" => "Coordination of Benefits", "291" => "Plan", "292" => "Benefit", "295" => "Primary Care Provider", "296" => "Initial Disability Period Return To Work", "297" => "Initial Disability Period Last Day Worked", "300" => "Enrollment Signature Date", "301" => "Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event", "303" => "Maintenance Effective", "304" => "Latest Visit or Consultation", "307" => "Eligibility", "314" => "Disability", "318" => "Added", "336" => "Employment Begin", "337" => "Employment End", "338" => "Medicare Begin", "339" => "Medicare End", "340" => "Consolidated Omnibus Budget Reconciliation Act (COBRA) Begin", "341" => "Consolidated Omnibus Budget Reconciliation Act (COBRA) End", "342" => "Premium Paid to Date Begin", "343" => "Premium Paid to Date End", "344" => "Coordination of Benefits Begin", "345" => "Coordination of Benefits End", "346" => "Plan Begin", "347" => "Plan End", "348" => "Benefit Begin", "349" => "Benefit End", "350" => "Education Begin", "351" => "Education End", "356" => "Eligibility Begin", "357" => "Eligibility End", "360" => "Initial Disability Period Start", "361" => "Initial Disability Period End", "382" => "Enrollment", "383" => "Adjusted Hire", "385" => "Credited Service Begin", "386" => "Credited Service End", "388" => "Payment Cancellation", "393" => "Plan Participation Suspension", "394" => "Rehire", "405" => "Production", "431" => "Onset of Current Symptoms or Illness", "434" => "Statement", "435" => "Admission", "439" => "Accident", "441" => "Prior Placement", "442" => "Date of Birth", "444" => "First Visit or Consultation", "446" => "Replacement", "452" => "Appliance Placement", "453" => "Acute Manifestation of a Chronic Condition", "454" => "Initial Treatment", "455" => "Last X-Ray", "458" => "Certification", "461" => "Last Certification", "463" => "Begin Therapy", "471" => "Prescription", "472" => "Service", "473" => "Medicaid Begin", "474" => "Medicaid End", "484" => "Last Menstrual Period", "523" => "Date of Claim", "539" => "Policy Effective", "540" => "Policy Expiration", "543" => "Last Premium Paid Date", "573" => "Date Claim Paid", "582" => "@todo", "607" => "Certification Revision", "636" => "Date of Last Update", "695" => "Previous Period", "738" => "Most Recent Hemoglobin or Hematocrit or Both", "739" => "Most Recent Serum Creatine", "754" => "Next Payment Due", "771" => "Status", "881" => "Request", "866" => "Examination", "903" => "Application Entry", "AAH" => "Event", "AB4" => "Time Period", "ABC" => "Estimated Date of Birth", "ABW" => "Credit Card Expiration", "AEC" => "Medicare Part A Coverage Effective Date", "AED" => "Medicare Part A Termination Date", "AEG" => "Medicare Part B Coverage Effective Date", "AEH" => "Medicare Part B Termination Date", "AFC" => "Medicare Part D Coverage Effective Date", "AFD" => "Medicare Part D Termination Date"))
- E380 =
t:: R.new(:E380 , "Quantity" , 1, 15)
- E426 =
t::ID.new(:E426 , "Adjustment Reason Code" , 2, 2, s::CodeList.build( "50" => "Late Charge", "51" => "Interest Penalty Charge", "72" => "Authorized Return", "90" => "Early Payment Allowance", "AH" => "Origination Fee", "AM" => "Applied to Borrower's Account", "AP" => "Acceleration of Benefits", "B2" => "Rebate", "B3" => "Recovery Allowance", "BD" => "Bad Debt Adjustment", "BN" => "Bonus", "C5" => "Temporary Allowance", "CR" => "Capitation Interest", "CS" => "Adjustment", "CT" => "Capitation Payment", "CV" => "Capital Passthru", "CW" => "Certified Registered Nurse Anesthetist Passthru", "DM" => "Direct Medical Education Passthru", "E3" => "Withholding", "FB" => "Forwarding Balance", "FC" => "Fund Allocation", "GO" => "Graduate Medicale Education Passthru", "HM" => "Hemophelia Clotting Factor Supplement", "IP" => "Incentive Premium Payment", "IR" => "Internal Revenue Service Withholding", "IS" => "Interim Settlement", "J1" => "Nonreimbursable", "L3" => "Penalty", "L6" => "Interest Owed", "LE" => "Levy", "LS" => "Lump Sum", "OA" => "Organ Acquisition Passthru", "OB" => "Offset for Affiliated Providers", "PI" => "Periodic Interim Payment", "PL" => "Payment Final", "RA" => "Retro-activity Adjustment", "RE" => "Return on Equity", "SL" => "Student Loan Repayment", "TL" => "Third Party Liability", "WO" => "Overpayment Recovery", "WU" => "Unspecified Recovery"))
- E429 =
t::AN.new(:E429 , "Check Number" , 1, 16)
- E443 =
t::AN.new(:E443 , "Contract Inquiry Reference" , 1, 20)
- E447 =
t::AN.new(:E447 , "Loop Identifier Code" , 1, 4)
- E449 =
t::AN.new(:E449 , "Fixed Format Information" , 1, 80)
- E478 =
t::ID.new(:E478 , "Credit/Debit Flag Code" , 1, 1, s::CodeList.build( "C" => "Credit", "D" => "Debit", "ACH" => "Automated Clearing House (ACH)", "BOP" => "Financial Institution Option", "CHK" => "Check", "FWT" => "Federal Reserve Funds/Wire Transfer - Nonrepetitive", "NON" => "Non-Payment Data"))
- E479 =
t::ID.new(:E479 , "Functional Identifier Code" , 2, 2, s::CodeList.build( "AA" => "Account Analysis (822)", "AB" => "Logistics Service Request (219)", "AD" => "Individual Life, Annuity and Disability Application (267)", "AF" => "Application for Admission to Educational Institutions (189)", "AG" => "Application Advice (824)", "AH" => "Logistics Service Response (220)", "AI" => "Automotive Inspection Detail (928)", "AK" => "Student Educational Record (Transcript) Acknowledgment (131)", "AL" => "Set Cancellation (998) and Application Acceptance/Rejection Advice (499)", "AN" => "Return Merchandise Authorization and Notification (180)", "AO" => "Income or Asset Offset (521)", "AR" => "Warehouse Stock Transfer Shipment Advice (943)", "AS" => "Transportation Appointment Schedule Information (163)", "AT" => "Animal Toxicological Data (249)", "AW" => "Warehouse Inventory Adjustment Advice (947)", "BC" => "Business Credit Report (155)", "BE" => "Benefit Enrollment and Maintenance (834)", "BF" => "Business Entity Filings (105)", "BL" => "Motor Carrier Bill of Lading (211)", "BS" => "Shipment and Billing Notice (857)", "CA" => "Purchase Order Change Acknowledgment/Request - Seller Initiated (865)", "CB" => "Unemployment Insurance Tax Claim or Charge Information (153)", "CC" => "Clauses and Provisions (504)", "CD" => "Credit/Debit Adjustment (812)", "CE" => "Cartage Work Assignment (222)", "CF" => "Corporate Financial Adjustment Information (844 and 849)", "CG" => "Administrative Message (994)", "CH" => "Car Handling Information (420)", "CI" => "Consolidated Service Invoice/Statement (811)", "CJ" => "Manufacturer Coupon Family Code Structure (877)", "CK" => "Manufacturer Coupon Redemption Detail (881)", "CM" => "Component Parts Content (871)", "CN" => "Coupon Notification (887)", "CO" => "Cooperative Advertising Agreements (290)", "CP" => "Electronic Proposal Information (251, 805)", "CR" => "Rail Carhire Settlements (414)", "CS" => "Cryptographic Service Message (815)", "CT" => "Application Control Totals (831)", "CV" => "Commercial Vehicle Safety and Credentials Information Exchange (285)", "D3" => "Contract Completion Status (567)", "D4" => "Contract Abstract (561)", "D5" => "Contract Payment Management Report (568)", "DA" => "Debit Authorization (828)", "DD" => "Shipment Delivery Discrepancy Information (854)", "DF" => "Market Development Fund Allocation (883)", "DI" => "Dealer Information (128)", "DM" => "Shipper's Car Order (422)", "DS" => "Data Status Tracking (242)", "DX" => "Direct Exchange Delivery and Return Information (894, 895)", "EC" => "Educational Course Inventory (188)", "ED" => "Student Educational Record (Transcript) (130)", "EI" => "Railroad Equipment Inquiry or Advice (456)", "ER" => "Revenue Receipts Statement (170)", "ES" => "Notice of Employment Status (540)", "EV" => "Railroad Event Report (451)", "EX" => "Excavation Communication (620)", "FA" => "Functional Acknowledgment (997, 999)", "FB" => "Freight Invoice (859)", "FC" => "Court and Law Enforcement Information (175, 176)", "FG" => "Motor Carrier Loading and Route Guide (217)", "FH" => "Motor Carrier Tariff Information (218)", "FR" => "Financial Reporting (821, 827)", "FT" => "File Transfer (996)", "GB" => "Average Agreement Demurrage (423)", "GC" => "Damage Claim Transaction Sets (920, 924, 925, 926)", "GE" => "General Request, Response or Confirmation (814)", "GF" => "Response to a Load Tender (990)", "GL" => "Intermodal Group Loading Plan (715)", "GP" => "Grocery Products Invoice (880)", "GR" => "Statistical Government Information (152)", "GT" => "Grant or Assistance Application (194)", "HB" => "Eligibility, Coverage or Benefit Information (271)", "HC" => "Health Care Claim (837)", "HI" => "Health Care Services Review Information (278)", "HN" => "Health Care Claim Status Notification (277)", "HP" => "Health Care Claim Payment/Advice (835)", "HR" => "Health Care Claim Status Request (276)", "HS" => "Eligibility, Coverage or Benefit Inquiry (270)", "IA" => "Air Freight Details and Invoice (110, 980)", "IB" => "Inventory Inquiry/Advice (846)", "IC" => "Rail Advance Interchange Consist (418)", "ID" => "Insurance/Annuity Application Status (273)", "IE" => "Insurance Producer Administration (252)", "IG" => "Direct Store Delivery Summary Information (882)", "II" => "Rail Freight Details and Invoice Summary (411)", "IJ" => "Report of Injury, Illness or Incident (148)", "IM" => "Motor Carrier Freight Details and Invoice (210, 980)", "IN" => "Invoice Information (810,819)", "IO" => "Ocean Shipment Billing Details (310, 312, 980)", "IP" => "Intermodal Ramp Activity (622)", "IR" => "Rail Carrier Freight Details and Invoice (410, 980)", "IS" => "Estimated Time of Arrival and Car Scheduling (421)", "KM" => "Commercial Vehicle Credentials (286)", "LA" => "Federal Communications Commission (FCC) License Application (195)", "LB" => "Lockbox (823)", "LI" => "Locomotive Information (436)", "LN" => "Property and Casualty Loss Notification (272)", "LR" => "Logistics Reassignment (536)", "LS" => "Asset Schedule (851)", "LT" => "Student Loan Transfer and Status Verification (144)", "MA" => "Motor Carrier Summary Freight Bill Manifest (224)", "MC" => "Request for Motor Carrier Rate Proposal (107)", "MD" => "Department of Defense Inventory Management (527)", "ME" => "Mortgage Origination (198, 200, 201, 261, 262, 263, 833, 872)", "MF" => "Market Development Funds Settlement (884)", "MG" => "Mortgage Servicing Transaction Sets (203, 206, 260, 264, 266)", "MH" => "Motor Carrier Rate Proposal (106)", "MI" => "Motor Carrier Shipment Status Inquiry (213)", "MJ" => "Secondary Mortgage Market Loan Delivery (202)", "MK" => "Response to a Motor Carrier Rate Proposal (108)", "MM" => "Medical Event Reporting (500)", "MN" => "Mortgage Note (205)", "MO" => "Maintenance Service Order (650)", "MP" => "Motion Picture Booking Confirmation (159)", "MQ" => "Consolidators Freight Bill and Invoice (223)", "MR" => "Multilevel Railcar Load Details (125)", "MS" => "Material Safety Data Sheet (848)", "MT" => "Electronic Form Structure (868)", "MV" => "Material Obligation Validation (517)", "MW" => "Rail Waybill Response (427)", "MX" => "Material Claim (847)", "MY" => "Response to a Cartage Work Assignment (225)", "NC" => "Nonconformance Report (842)", "NL" => "Name and Address Lists (101)", "NP" => "Notice of Power of Attorney (157)", "NT" => "Notice of Tax Adjustment or Assessment (149)", "OC" => "Cargo Insurance Advice of Shipment (362)", "OG" => "Order Group - Grocery (875, 876)", "OR" => "Organizational Relationships (816)", "OW" => "Warehouse Shipping Order (940)", "PA" => "Price Authorization Acknowledgment/Status (845)", "PB" => "Railroad Parameter Trace Registration (455)", "PC" => "Purchase Order Change Request - Buyer Initiated (860)", "PD" => "Product Activity Data (852)", "PE" => "Periodic Compensation (256)", "PF" => "Annuity Activity (268)", "PG" => "Insurance Plan Description (100)", "PH" => "Pricing History (503)", "PI" => "Patient Information (275)", "PJ" => "Project Schedule Reporting (806)", "PK" => "Project Cost Reporting (839) and Contractor Cost Data Reporting (196)", "PL" => "Railroad Problem Log Inquiry or Advice (452)", "PN" => "Product Source Information (244)", "PO" => "Purchase Order (850)", "PQ" => "Property Damage Report (112)", "PR" => "Purchase Order Acknowledgement (855)", "PS" => "Planning Schedule with Release Capability (830)", "PT" => "Product Transfer and Resale Report (867)", "PU" => "Motor Carrier Shipment Pick-up Notification (216)", "PV" => "Purchase Order Shipment Management Document (250)", "PY" => "Payment Cancellation Request (829)", "QG" => "Product Information (878, 879, 888, 889, 893, 896)", "QM" => "Transportation Carrier Shipment Status Message (214)", "QO" => "Ocean Shipment Status Information (313, 315)", "RA" => "Payment Order/Remittance Advice (820)", "RB" => "Railroad Clearance (470)", "RC" => "Receiving Advice/Acceptance Certificate (861)", "RD" => "Royalty Regulatory Report (185)", "RE" => "Warehouse Stock Receipt Advice (944)", "RH" => "Railroad Reciprocal Switch File (433)", "RI" => "Routing and Carrier Instruction (853)", "RJ" => "Railroad Mark Register Update Activity (434)", "RK" => "Standard Transportation Commodity Code Master (435)", "RL" => "Rail Industrial Switch List (423)", "RM" => "Railroad Station Master File (431)", "RN" => "Requisition Transaction (511)", "RO" => "Ocean Booking Information (300, 301,303)", "RP" => "Commission Sales Report (818)", "RQ" => "Request for Quotation (840) and Procurement Notices (836)", "RR" => "Response to Request For Quotation (843)", "RS" => "Order Status Information (869, 870)", "RT" => "Report of Test Results (863)", "RU" => "Railroad Retirement Activity (429)", "RV" => "Railroad Junctions and Interchanges Activity (437)", "RW" => "Rail Revenue Waybill (426)", "RX" => "Rail Deprescription (432)", "RY" => "Request for Student Educational Record (Transcript) (146)", "RZ" => "Response to Request for Student Educational Record (Transcript) (147)", "SA" => "Air Shipment Information (104)", "SB" => "Switch Rails (424)", "SC" => "Price/Sales Catalog (832)", "SD" => "Student Loan Pre-Claims and Claims (191)", "SE" => "Shipper's Export Declaration (601)", "SG" => "SG Receiving Advice - Grocery (885)", "SH" => "Ship Notice/Manifest (856)", "SI" => "Shipment Information (858)", "SJ" => "Transportation Automatic Equipment Identification (160)", "SL" => "Student Loan Application and Guarantee (135, 139)", "SM" => "Motor Carrier Load Tender (204)", "SN" => "Rail Route File Maintenance (475)", "SO" => "Ocean Shipment Information (304, 306, 309, 311, 317, 319, 321, 322, 323, 324, 325, 350, 352, 353, 354, 355, 356, 357, 358, 361)", "SP" => "Specifications/Technical Information (841)", "SQ" => "Production Sequence (866)", "SR" => "Rail Carrier Shipment Information (404, 419)", "SS" => "Shipping Schedule (862)", "ST" => "Railroad Service Commitment Advice (453)", "SU" => "Account Assignment/Inquiry and Service/Status (248)", "SV" => "Student Enrollment Verification (190)", "SW" => "Warehouse Shipping Advice (945)", "TA" => "Electronic Filing of Tax Return Data Acknowledgment (151)", "TC" => "Court Submission (176)", "TD" => "Trading Partner Profile (838)", "TF" => "Electronic Filing of Tax Return Data (813)", "TI" => "Tax Information Exchange (826)", "TM" => "Motor Carrier Delivery Trailer Manifest (212)", "TN" => "Tax Rate Notification (150)", "TO" => "Real Estate Title Services (197, 199, 265)", "TP" => "Rail Rate Transactions (460, 463, 466, 468, 485, 486, 490, 492, 494)", "TR" => "Train Sheet (161)", "TS" => "Transportation Services Tender (602)", "TT" => "Testing Results Request and Report (138)", "TX" => "Text Message (864)", "UA" => "Retail Account Characteristics (885)", "UB" => "Customer Call Reporting (886)", "UC" => "Uniform Commercial Code Filing (154)", "UD" => "Deduction Research Report (891)", "UI" => "Underwriting Information Services (255)", "UP" => "Motor Carrier Pick-up Manifest (215)", "UW" => "Insurance Underwriting Requirements Reporting (186)", "VA" => "Vehicle Application Advice (126)", "VB" => "Vehicle Baying Order (127)", "VC" => "Vehicle Shipping Order (120)", "VD" => "Vehicle Damage (124)", "VE" => "Vessel Content Details (109)", "VH" => "Vehicle Carrier Rate Update (129)", "VI" => "Voter Registration Information (280)", "VS" => "Vehicle Service (121)", "WA" => "Product Service Transaction Sets (140, 141, 142, 143)", "WB" => "Rail Carrier Waybill Interchange (417)", "WG" => "Vendor Performance Review (501)", "WI" => "Wage Determination (288)", "WL" => "Well Information (625)", "WR" => "Shipment Weights (440)", "WT" => "Rail Waybill Request (425)"))
- E455 =
t::ID.new(:E455 , "Responsible Agency Code" , 1, 2, s::CodeList.build( "X" => "Accredited Standards Committee X12"))
- E480 =
t::AN.new(:E480 , "Version / Release / Identifier Code" , 1, 12, s::CodeList.external("881"))
- E481 =
t::ID.new(:E481 , "Trace Type Code" , 1, 2, s::CodeList.build( "1" => "Current Transaction Trace Numbers", "2" => "Referenced Transaction Trace Numbers", "3" => "@todo"))
- E499 =
t::AN.new(:E499 , "Condition Value" , 1, 10)
- E506 =
t::ID.new(:E506 , "DFI Identification Number Qualifier" , 2, 2, s::CodeList.build( "01" => s::CodeList.external("4"), "04" => s::CodeList.external("91")))
- E507 =
t::AN.new(:E507 , "DFI Identification Number" , 3, 12, s::CodeList.external("60"))
- E508 =
t::AN.new(:E508 , "Account Number" , 1, 35)
- E509 =
t::AN.new(:E509 , "Originating Company Identifier" , 10,10)
- E510 =
t::AN.new(:E510 , "Originating Company Supplemental Code", 9, 9)
- E522 =
t::ID.new(:E522 , "Amount Qualifier Code" , 1, 3, s::CodeList.build( "93" => "Contribution", "A8" => "Noncovered Charges - Actual", "AU" => "Coverage Amount", "B6" => "Allowed Amount", "B9" => "Co-insurance - Actual", "C1" => "Co-Payment Amount", "D" => "Payor Amount Paid", "D2" => "Deductible Amount", "D8" => "Discount Amount", "DY" => "Per Day Limit", "EAF" => "Amount Owed", "EBA" => "Expected Expenditure Amount", "F3" => "Patient Responsibility - Estimated", "F4" => "Postage Claimed", "F5" => "Patient Amount Paid", "FK" => "Other Unlisted Amount", "GT" => "Goods and Services Tax", "I" => "Interest", "JN" => "Employer Contribution", "KH" => "Deduction Amount", "N8" => "Miscellaneous Taxes", "NL" => "Negative Ledger Balance", "P3" => "Premium Amount", "T3" => "Total Submitted Charges", "PB" => "Billed Amount", "R" => "Spend Down", "SCT" => "State Care Tax", "T" => "Tax", "T2" => "Total Claim Before Taxes", "YU" => "In Process", "YY" => "Returned", "ZK" => "Federal Medicare or Medicaid Payment Mandate Category 1", "ZL" => "Federal Medicare or Medicaid Payment Mandate Category 2", "ZM" => "Federal Medicare or Medicaid Payment Mandate Category 3", "ZN" => "Federal Medicare or Medicaid Payment Mandate Category 4", "ZO" => "Federal Medicare or Medicaid Payment Mandate Category 5"))
- E554 =
t::Nn.new(:E554 , "Assigned Number" , 1, 6, 0)
- E559 =
t::ID.new(:E559 , "Agency Qualifier Code" , 2, 2, s::CodeList.build( "LB" => s::CodeList.external("407")))
- E569 =
t::ID.new(:E569 , "Account Number Qualifier" , 1, 3, s::CodeList.build( "DA" => "Demand Deposit", "SG" => "Savings"))
- E584 =
t::ID.new(:E584 , "Employment Status Code" , 2, 2, s::CodeList.build( "AC" => "Active", "AE" => "@todo", "AO" => "Active Military - Overseas", "AU" => "Active Military - USA", "AS" => "@todo", "AT" => "@todo", "CC" => "@todo", "DD" => "@todo", "DI" => "Deceased", "HD" => "@todo", "IR" => "@todo", "FT" => "Full-time", "L1" => "Leave of Absence", "LX" => "@todo", "PE" => "@todo", "PT" => "Part-time", "PV" => "Previous", "RE" => "@todo", "RM" => "@todo", "RR" => "@todo", "RU" => "Retired Military - USA", "RT" => "Retired", "TE" => "Terminated"))
- E591 =
t::ID.new(:E591 , "Payment Method Code" , 3, 3)
- E594 =
t::ID.new(:E594 , "Frequency Code" , 1, 1, s::CodeList.build( "1" => "Weekly", "2" => "Biweekly", "3" => "Semimonthly", "4" => "Monthly", "6" => "Daily", "7" => "Annual", "8" => "Two Calendar Months", "9" => "Lump-Sum Separation Allowance", "B" => "Year-to-Date", "C" => "Single", "H" => "Hourly", "Q" => "Quarterly", "S" => "Semiannual", "U" => "Unknown"))
- E609 =
t::Nn.new(:E609 , "Count" , 1, 9, 0)
- E615 =
t::ID.new(:E615 , "Time Period Qualifier" , 1, 2, s::CodeList.build( "6" => "Hour", "7" => "Day", "13" => "24 Hours", "21" => "Years", "22" => "Service Year", "23" => "Calendar Year", "24" => "Year to Date", "25" => "Contract", "26" => "Episode", "27" => "Visit", "28" => "Outlier", "29" => "Remaining", "30" => "Exceeded", "31" => "Not Exceeded", "32" => "Lifetime", "33" => "Lifetime Remaining", "34" => "Month", "35" => "Week", "36" => "Admission"))
- E616 =
t::Nn.new(:E616 , "Number of Periods" , 1, 3, 0)
- E618 =
t::ID.new(:E618 , "Implementation Transaction Set Syntax Error Code", 1, 3, s::CodeList.build( "1" => "Transaction Set Not Supported", "2" => "Transaction Set Trailer Missing", "3" => "Transaction Set Control Number in Header and Trailer Do Not Match", "4" => "Number of Included Segments Does Not Match Actual Content", "5" => "One or More Segments in Error", "6" => "Missing or Invalid Transaction Set Identifier", "7" => "Missing or Invalid Transaction Set Control Number", "8" => "Authentication Key Name Unknown", "9" => "Encryption Key Name Unknown", "10" => "Requested Service (Authentication or Encrypted) Not Available", "11" => "Unknown Security Recipient", "12" => "Incorrect Message Length (Encryption Only)", "13" => "Message Authentication Code Failed", "15" => "Unknown Security Originator", "16" => "Syntax Error in Decrypted Text", "17" => "Security Not Supported", "18" => "Transaction Set not in Functional Group", "19" => "Invalid Transaction Set Implementation Convention Reference", "23" => "Transaction Set Control Number Not Unique within the Functional Group", "24" => "S3E Security End Segment Missing for S3S Security Start Segment", "25" => "S3S Security Start Segment Missing for S3E Security End Segment", "26" => "S4E Security End Segment Missing for S4S Security Start Segment", "27" => "S4S Security Start Segment Missing for S4E Security End Segment", "I5" => "Implementation One or More Segments In Error", "I6" => "Implementation Convention Not Supported"))
- E620 =
t::ID.new(:E620 , "Implementation Segment Syntax Error Code", 1, 3, s::CodeList.build( "1" => "Unrecognized segment ID", "2" => "Unexpected segment", "3" => "Required Segment Missing", "4" => "Loop Occurs Over Maximum Times", "5" => "Segment Exceeds Maximum Use", "6" => "Segment Not in Defined Transaction Set", "7" => "Segment Not in Proper Sequence", "8" => "Segment Has Data Element Errors", "I4" => "Implementation 'Not Used' Segment Present", "I6" => "Implementation Dependent Segment Missing", "I7" => "Implementation Loop Occurs Under Minimum Times", "I8" => "Implementation Segment Below Minimum Use", "I9" => "Implementation Dependent 'Not Used' Segment Present"))
- E621 =
t::ID.new(:E621 , "Implementation Data Element Syntax Error Code", 1, 3, s::CodeList.build( "1" => "Required Data Element Missing", "2" => "Conditional Required Data Element Missing", "3" => "Too Many Data Elements", "4" => "Data Element Too Short", "5" => "Data Element Too Long", "6" => "Invalid Character In Data Element", "7" => "Invalid Code Value", "8" => "Invalid Date", "9" => "Invalid Time", "10" => "Exclusion Conditional Violated", "12" => "Too Many Repetitions", "13" => "Too Many Components", "I6" => "Code Value Not Used in Implementation", "I9" => "Implementation Dependent Data Element Missing", "I10" => "Implementation 'Not Used' Data Element Present", "I11" => "Implementation Too Few Repetitions", "I12" => "Implementation Pattern Match Failure", "I13" => "Implementation Dependent 'Not Used' Data Element Present"))
- E623 =
t::ID.new(:E623 , "Time Code" , 2, 2, s::CodeList.build( "01" => "Equivalent to ISO P01", "02" => "Equivalent to ISO P02", "03" => "Equivalent to ISO P03", "04" => "Equivalent to ISO P04", "05" => "Equivalent to ISO P05", "06" => "Equivalent to ISO P06", "07" => "Equivalent to ISO P07", "08" => "Equivalent to ISO P08", "09" => "Equivalent to ISO P09", "10" => "Equivalent to ISO P10", "11" => "Equivalent to ISO P11", "12" => "Equivalent to ISO P12", "13" => "Equivalent to ISO M12", "14" => "Equivalent to ISO M11", "15" => "Equivalent to ISO M10", "16" => "Equivalent to ISO M09", "17" => "Equivalent to ISO M08", "18" => "Equivalent to ISO M07", "19" => "Equivalent to ISO M06", "20" => "Equivalent to ISO M05", "21" => "Equivalent to ISO M04", "22" => "Equivalent to ISO M03", "23" => "Equivalent to ISO M02", "24" => "Equivalent to ISO M01", "AD" => "Alaska Daylight Time", "AS" => "Alaska Standard Time", "AT" => "Alaska Time", "CD" => "Central Daylight Time", "CS" => "Central Standard Time", "CT" => "Central Time", "ED" => "Eastern Daylight Time", "ES" => "Eastern Standard Time", "ET" => "Eastern Time", "GM" => "Greenwich Mean Time", "HD" => "Hawaii-Aleutian Daylight Time", "HS" => "Hawaii-Aleutian Standard Time", "HT" => "Hawaii-Aleutian Time", "LT" => "Local Time", "MD" => "Mountain Daylight Time", "MS" => "Mountain Standard Time", "MT" => "Mountain Time", "ND" => "Newfoundland Daylight Time", "NS" => "Newfoundland Standard Time", "NT" => "Newfoundland Time", "PD" => "Pacific Daylight Time", "PS" => "Pacific Standard Time", "PT" => "Pacific Time", "TD" => "Atlantic Daylight Time", "TS" => "Atlantic Standard Time", "TT" => "Atlantic Time", "UT" => "Universal Time Coordinate"))
- E628 =
t::AN.new(:E628 , "Hierachical ID Number" , 1, 12)
- E639 =
t::ID.new(:E639 , "Basis of Unit Price Code" , 2, 2)
- E640 =
t::ID.new(:E640 , "Transaction Type Code" , 2, 2, s::CodeList.build( "18" => "Response - No Further Updates to Follow", "19" => "Response - Further Updates to Follow", "31" => "Subrogation Demand", "CH" => "Chargeable", "DG" => "Response", "NO" => "Notice", "P5" => "Predetermination - Medical", "P6" => "Predetermination - Dental", "RD" => "Returns Detail", "RP" => "Reporting", "RQ" => "Request", "RS" => "Response - Additional Response(s) Available", "RT" => "Spend Down", "RU" => "Medical Services Reservation", "TH" => "Receipt Acknowledgement Advice", "ZW" => "Sort and Segregate Detail"))
- E648 =
t::ID.new(:E648 , "Price Multiplier Qualifier" , 3, 3)
- E649 =
t:: R.new(:E649 , "Multiplier" , 1, 10)
- E659 =
t::ID.new(:E659 , "Basis of Verification Code" , 1, 2)
- E669 =
t::ID.new(:E669 , "Currency Market/Exchnage Code" , 3, 3)
- E673 =
t::ID.new(:E673 , "Quantity Qualifier" , 2, 2, s::CodeList.build( "8H" => "Minimum", "90" => "Acknowledged Quantity", "99" => "Quantity Used", "AA" => "Unacknowledged Quantity", "CA" => "Covered - Actual", "CD" => "Co-insured - Actual", "CE" => "Covered - Estimated", "D3" => "Number of Co-insurance Days", "DB" => "Deductible Blood Units", "DY" => "Days", "FA" => "Facility Identification", "FI" => "Federal Taxpayer's Identification Number", "DT" => "Dependent Total", "ET" => "Employee Total", "FL" => "Units", "HS" => "Hours", "II" => "Standard Unique Health Identifier For Each Individual In The United States", "LA" => "Life-time Reserve - Actual", "LE" => "Life-time Reserve - Estimated", "M2" => "Maximum", "MI" => "Member Identification Number", "MN" => "Month", "NE" => "Non-Covered Amount - Estimated", "NI" => "National Association of Insurance Commissioners (NAIC) Identification", "NR" => "Not Replaced Blood Units", "OU" => "Outlier Days", "P6" => "Number of Services or Procedures", "PI" => "Payor Identification", "PP" => "Pharmacy Processor Number", "PS" => "Prescription", "PT" => "Patients", "QA" => "Quantity Approved", "QC" => "Quantity Disapproved", "S7" => "Age, High Value", "S8" => "Age, Low Value", "SV" => "Service Provider Number", "TO" => "Total", "VS" => "Visits", "XV" => s::CodeList.external("540"), "XX" => s::CodeList.external("537"), "YY" => "Years", "ZK" => "Federal Medicare or Medicaid Payment Mandate Category 1", "ZL" => "Federal Medicare or Medicaid Payment Mandate Category 2", "ZM" => "Federal Medicare or Medicaid Payment Mandate Category 3", "ZN" => "Federal Medicare or Medicaid Payment Mandate Category 4", "ZO" => "Federal Medicare or Medicaid Payment Mandate Category 5"))
- E678 =
t::ID.new(:E678 , "Ship/Delivery or Calendar Pattern Code", 1, 2, s::CodeList.build( "1" => "1st Week of the Month", "2" => "2nd Week of the Month", "3" => "3rd Week of the Month", "4" => "4th Week of the Month", "5" => "5th Week of the Month", "6" => "1st & 3rd Weeks of the Month", "7" => "2nd & 4th Weeks of the Month", "8" => "1st Working Day of Period", "9" => "Last Working Day of Period", "A" => "Monday through Friday", "B" => "Monday through Saturday", "C" => "Monday through Sunday", "D" => "Monday", "E" => "Tuesday", "F" => "Wednesday", "G" => "Thursday", "H" => "Friday", "J" => "Saturday", "K" => "Sunday", "L" => "Monday through Thursday", "M" => "Immediately", "N" => "As Directed", "O" => "Daily Mon. through Fri.", "P" => "1/2 Mon. & 1/2 Thurs.", "Q" => "1/2 Tues. & 1/2 Thurs.", "R" => "1/2 Wed. & 1/2 Fri.", "S" => "Once Anytime Mon. through Fri.", "SG" => "Tuesday through Friday", "SL" => "Monday, Tuesday and Thursday", "SP" => "MOnday, Tuesday and Friday", "SX" => "Wednesday and Thursday", "SY" => "Monday, Wednesday and Thursday", "SZ" => "Tuesday, Thursday and Friday", "SGT" => "uesday through Friday", "SLM" => "onday, Tuesday and Thursday", "SPM" => "onday, Tuesday and Friday", "SXW" => "ednesday and Thursday", "SYM" => "onday, Wednesday and Thursday", "SZT" => "uesday, Thursday and Friday", "T" => "1/2 Tue. & 1/2 Fri.", "U" => "1/2 Mon. & 1/2 Wed.", "V" => "1/3 Mon., 1/3 Wed., 1/3 Fri.", "W" => "Whenever Necessary", "X" => "1/2 By Wed., Bal. By Fri.", "Y" => "None (Also Used to Cancel or Override a Previous Pattern)"))
- E679 =
t::ID.new(:E679 , "Ship/Delivery Pattern Time Code" , 1, 1, s::CodeList.build( "A" => "1st Shift (Normal Working Hours)", "B" => "2nd Shift", "C" => "3rd Shift", "D" => "A.M.", "E" => "P.M.", "F" => "As Directed", "G" => "Any Shift", "Y" => "None (Also Used to Cancel or Override a Previous Pattern)"))
- E687 =
t::ID.new(:E687 , "Class of Trade Code" , 2, 2)
- E704 =
t::ID.new(:E704 , "Paperwork/Report Action Code" , 1, 2)
- E706 =
Note:
Copied from an unverified source
t::ID.new(:E706 , "Entity Relation Code" , 2, 2)
- E715 =
t::ID.new(:E715 , "Functional Group Acknowledgment Code" , 1, 1, s::CodeList.build( "A" => "Accepted", "E" => "Accepted, But Errors Were Noted", "M" => "Rejected, Message Authentication Code (MAC) Failed", "P" => "Partially Accepted, At Least One Transaction Set Was Rejected", "R" => "Rejected", "W" => "Rejected, Assurance Failed Validity Tests", "X" => "Rejected, Content After Decryption Could Not Be Analyzed"))
- E716 =
t::ID.new(:E716 , "Functional Group Syntax Error Code" , 1, 3, s::CodeList.build( "1" => "Functional Group Not Supported", "2" => "Functional Group Version Not Supported", "3" => "Functional Group Trailer Missing", "4" => "Group Control Number in the Functional Group Header and Trailer Do Not Agree", "5" => "Number of Included Transaction Sets Does Not Match Actual Count", "6" => "Group Control Number Violates Syntax", "10" => "Authentication Key Name Unknown", "11" => "Encryption Key Name Unknown", "12" => "Requested Service (Authentication or Encryption) Not Available", "13" => "Unknown Security Recipient", "14" => "Unknown Security Originator", "15" => "Syntax Error in Decrypted Text", "16" => "Security Not Supported", "17" => "Incorrect Message Length (Encryption Only)", "18" => "Message Authentication Code Failed", "19" => "Functional Group Control Number not Unique within Interchange", "23" => "S3E Security End Segment Missing for S3S Security Start Segment", "24" => "S3S Security Start Segment Missing for S3E Security End Segment", "25" => "S4E Security End Segment Missing for S4S Security Start Segment", "26" => "S4S Security Start Segment Missing for S4E Security End Segment"))
- E717 =
t::ID.new(:E717 , "Transaction Set Acknowledgment Code" , 1, 1, s::CodeList.build( "A" => "Accepted", "E" => "Accepted But Errors Were Reported", "M" => "Rejected, Message Authentication Code (MAC) Failed", "R" => "Rejected", "W" => "Rejected, Assurance Failed Validity Tests", "X" => "Rejected, Content After Decryption Could Not Be Analyzed"))
- E718 =
t::ID.new(:E718 , "Transaction Set Syntax Error Code" , 1, 3)
- E719 =
t::Nn.new(:E719 , "Segment Position in Transaction Set" , 1, 10, 0)
- E720 =
t::ID.new(:E720 , "Segment Syntax Error Code" , 1, 3)
- E721 =
t::ID.new(:E721 , "Segment ID Code" , 2, 3, s::CodeList.external("77"))
- E722 =
t::Nn.new(:E722 , "Element Position in Segment" , 1, 2, 0)
- E723 =
t::ID.new(:E723 , "Data Element Syntax Error Code" , 1, 3)
- E724 =
t::AN.new(:E724 , "Copy of Bad Data Element" , 1, 99)
- E725 =
t::Nn.new(:E725 , "Data Element Reference Number" , 1, 4, 0)
- E734 =
t::AN.new(:E734 , "Hierarchical Parent ID Number" , 1, 12)
- E735 =
t::ID.new(:E735 , "Hierarchical Level Code" , 1, 2, s::CodeList.build( "19" => "Provider of Service", "20" => "Information Source", "21" => "Information Receiver", "22" => "Subscriber", "23" => "Dependent", "EV" => "Event", "PT" => "Patient", "SS" => "Services"))
- E736 =
t::ID.new(:E736 , "Hierarchical Child Code" , 1, 1, s::CodeList.build( "0" => "No Subordinate HL Segment in This Hierarchical Structure", "1" => "Additional Subordinate HL Data Segment in This Hierarchical Structure"))
- E737 =
t::ID.new(:E737 , "Measurement Reference ID Code" , 2, 2, s::CodeList.build( "OG" => "Original", "TR" => "Test Results"))
- E738 =
t::ID.new(:E738 , "Measurement Qualifier" , 2, 2, s::CodeList.build( "HT" => "Height", "R1" => "Hemoglobin", "R2" => "Hematocrit", "R3" => "Epoetin Starting Dosage", "R4" => "Creatinine"))
- E739 =
t:: R.new(:E739 , "Measurement Value" , 1, 20)
- E740 =
t:: R.new(:E740 , "Range Minimum" , 1, 20)
- E741 =
t:: R.new(:E741 , "Range Maximum" , 1, 20)
- E752 =
t::ID.new(:E752 , "Surface/Layer/Position Code" , 2, 2)
- E753 =
t::ID.new(:E753 , "Measurement Method or Device" , 2, 4)
- E755 =
t::ID.new(:E755 , "Report Type Code" , 2, 2, s::CodeList.build( "03" => "Report Justifying Treatment Beyond Utilization Guidelines", "04" => "Drugs Administered", "05" => "Treatment Diagnosis", "06" => "Initial Assesment", "07" => "Functional Goals", "08" => "Plan of Treatment", "09" => "Progress Report", "10" => "Continued Treatment", "11" => "Chemical Analysis", "13" => "Certified Test Report", "15" => "Justification for Admission", "21" => "Recovery Plan", "48" => "Social Security Benefit Letter", "55" => "Rental Agreement", "59" => "Benefit Letter", "77" => "Support Data for Verification", "A3" => "Allergies/Sensitivies Document", "A4" => "Autopsy Report", "AM" => "Ambulance Certification", "AS" => "Admission Summary", "B2" => "Prescription", "B3" => "Physician Order", "B4" => "Referral Form", "BR" => "Benchmark Testing Results", "BS" => "Baseline", "BT" => "Blanket Test Results", "CB" => "Chiropractic Justification", "CK" => "Conset Form(s)", "CT" => "Certification", "D2" => "Drug Profile Document", "DA" => "Dental Models", "DB" => "Durable Medical Equipment Prescription", "DG" => "Diagnostic Report", "DJ" => "Discharge Monitoring Report", "DS" => "Discharge Summary", "EB" => "Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer)", "FM" => "Family Medical History Document", "HC" => "Health Cerification", "HR" => "Health Clinic Records", "I5" => "Immunization Record", "IR" => "State School Immunization Records", "LA" => "Laboratory Results", "M1" => "Medical Record Attachment", "MT" => "Models", "NN" => "Nursing Notes", "OB" => "Operative Note", "OC" => "Oxygen Content Averaging Report", "OD" => "Orders and Treatments Document", "OE" => "Objective Physical Examination (including vital signs) Document", "OX" => "Oxygen Therapy Certification", "OZ" => "Support Data for Claim", "P4" => "Pathology Report", "P5" => "Patient Medical History Document", "P6" => "Periodontal Charts", "PE" => "Parenteral or Enteral Certification", "PN" => "Physical Therapy Notes", "PO" => "Prosthetics or Orthotic Certification", "PQ" => "Paramedical Results", "PY" => "Physician's Report", "PZ" => "Physical Therapy Certification", "RB" => "Radiology Films", "RR" => "Radiology Reports", "RT" => "Report of Tests and Analysis Report", "RX" => "Renewable Oxygen Content Averaging Report", "SG" => "Symptoms Document", "V5" => "Death Notification", "XP" => "Photographs"))
- E756 =
t::ID.new(:E756 , "Report Transmission Code" , 1, 2, s::CodeList.build( "AA" => "Available on Request at Provider Site", "AB" => "Previously Submitted to Payer", "AD" => "Certification Included in this Claim", "AF" => "Narrative Segment Included in this Claim", "AG" => "No Documentation is Required", "BM" => "By Mail", "EL" => "Electronically Only", "EM" => "E-Mail", "FT" => "File Transfer", "FX" => "By Fax", "NS" => "Not Specified", "OL" => "On-Line", "VO" => "Voice"))
- E757 =
t::Nn.new(:E757 , "Report Copies Needed" , 1, 2, 0)
- E782 =
t:: R.new(:E782 , "Monetary Amount" , 1, 18)
- E786 =
t::ID.new(:E786 , "Security Level Code" , 2, 2, s::CodeList.build( "00" => "Company Non-Classified", "01" => "Company Internal Use Only", "02" => "Company Confidential", "03" => "Company Confidential, Restricted (Need to Know)", "04" => "Company Registered (Signature Required)", "05" => "Personal", "06" => "Supplier Proprietary", "09" => "Company Defined (Trading Partner Level)", "11" => "Competition Sensitive", "20" => "Court Restricted", "21" => "Juvenile Record Restricted", "90" => "Government Non-Classified", "92" => "Government Confidential", "93" => "Government Secret", "94" => "Government Top Secret", "99" => "Government Defined (Trading Partner Level)", "ZZ" => "Mutually Defined"))
- E799 =
t::AN.new(:E799 , "Version Identifier" , 1, 30)
- E812 =
t::ID.new(:E812 , "Payment Format Code" , 3, 3, s::CodeList.build( "CCP" => "Cash Concentration/Disbursement plus Addenda (CCD+)(ACH)", "CTX" => "Corporate Trade Exchange (CTX) (ACH)"))
- E875 =
t::ID.new(:E875 , "Maintenance Type Code" , 3, 3, s::CodeList.build( "001" => "Change", "002" => "Delete", "021" => "Addition", "024" => "Cancellation or Termination", "025" => "Reinstatement", "026" => "Correction", "030" => "Audit or Compare", "032" => "Employee Information Not Applicable"))
- E889 =
t::ID.new(:E889 , "Follow-up Action Code" , 1, 1, s::CodeList.build( "C" => "Please Correct and Resubmit", "N" => "Resubmission Not Allowed", "P" => "Please Resubmit Original Transaction", "R" => "Resubmission Allowed", "S" => "Do Not Resubmit; Inquiry Initiated to a Third Party", "W" => "Please Wait 30 Days and Resubmit", "X" => "Please Wait 10 Days and Resubmit", "Y" => "Do Not Resubmit; We Will Hold Your Request and Respond Again Shortly"))
- E901 =
t::ID.new(:E901 , "Reject Reason Code" , 2, 2, s::CodeList.build( "04" => "Authorization Quantity Exceeded", "15" => "Required Application Data Missing", "33" => "Input Errors", "35" => "Out of Network", "41" => "Authorization/Access Restrictions", "42" => "Unable to Respond at Current Time", "43" => "Invalid/Missing Provider Identification", "44" => "Invalid/Missing Provider Name", "45" => "Invalid/Missing Provider Specialty", "46" => "Invalid/Missing Provider Phone Number", "47" => "Invalid/Missing Provider State", "48" => "Invalid/Missing Referring Provider Identification Number", "49" => "Provider is Not Primary Care Physician", "50" => "Provider Ineligible for Inquiries", "51" => "Provider Not on File", "52" => "Service Dates Not Within Provider Plan Enrollment", "53" => "Inquired Benefit Inconsistent with Provider Type", "54" => "Inappropriate Product/Service ID Qualifier", "55" => "Inappropriate Product/Service ID", "56" => "Inappropriate Date", "57" => "Invalid/Missing Date(s) of Service", "58" => "Invalid/Missing Date-of-Birth", "60" => "Date of Birth Follows Date(s) of Service", "61" => "Date of Death Preceeds Date(s) of Service", "62" => "Date of Service Not Within Allowable Inquiry Period", "63" => "Date of Service in Future", "64" => "Invalid/Missing Patient ID", "65" => "Invalid/Missing Patient Name", "66" => "Invalid/Missing Patient Gender Code", "67" => "Patient Not Found", "68" => "Duplicate Patient ID Number", "69" => "Inconsistent with Patient's Age", "70" => "Inconsistent with Patient's Gender", "71" => "Patient Birth Date Does Not Match That for the Patient on the Database", "72" => "Invalid/Missing Subscriber/Insured ID", "73" => "Invalid/Missing Subscriber/Insured Name", "74" => "Invalid/Missing Subscriber/Insured Gender Code", "75" => "Subscribed/Insured Not Found", "76" => "Duplicate Subscriber/Insured ID Number", "77" => "Subscriber Found, Patient Not Found", "78" => "Subscriber/Insured Not in Group/Plan Identified", "79" => "Invalid Participant Identification", "80" => "No Response Received - Transaction Terminated", "95" => "Patient Not Eligible", "97" => "Invalid or Missing Provider Address", "98" => "Experimental Service or Procedure", "AA" => "Authorization Number Not Found", "AE" => "Requires Primary Care Physician Authorization", "AF" => "Invalid/Missing Diagnosis Code(s)", "AG" => "Invalid/Missing Procedure Code(s)", "AO" => "Additional Patient Condition Information Required", "CI" => "Certification Information Does Not Match Patient", "E8" => "Requires Medical Review", "IA" => "Invalid Authorization Number Format", "IP" => "Inappropriate Provider Role", "MA" => "Missing Authorization Number", "NC" => "No Certification Information Found", "T1" => "Cannot Identify Provider as TPO (Third Party Organization) Participant", "T2" => "Cannot Identify Payer as TPO (Third Party Organization) Participant", "T3" => "Cannot Identify Insured as TPO (Third Party Organization) Participant", "T4" => "Payer Name or Identifier Missing", "T5" => "Certification Information Missing", "T6" => "Claim does not contain enough information for re-pricing"))
- E923 =
t::ID.new(:E923 , "Prognosis Code" , 1, 1, s::CodeList.build( "1" => "Poor", "2" => "Guarded", "3" => "Fair", "4" => "Good", "5" => "Very Good", "6" => "Excellent", "7" => "Less than 6 Months to Live", "8" => "Terminal"))
- E933 =
t::AN.new(:E933 , "Free-form Message Text" , 1, 264)
- E934 =
t::AN.new(:E934 , "Printer Carriage Control Code" , 2, 2)
- E935 =
t::ID.new(:E935 , "Measurement Significance Code" , 2, 2)
- E936 =
t::ID.new(:E936 , "Measurement Attribute Code" , 2, 2)
- E954 =
t:: R.new(:E954 , "Percentage as Decimal" , 1, 10)
- E1005 =
t::ID.new(:E1005, "Hierarchical Structure Code" , 4, 4, s::CodeList.build( "0007" => "Information Source, Information Receiver, Subscriber, Dependent, Event, Services", "0010" => "Information Source, Information Receiver, Provider of Service, Subscriber, Dependent", "0019" => "Information Source, Subscriber, Dependent", "0022" => "Information Source, Information Receiver, Subscriber, Dependent", "0085" => "Information Source, Information Receiver, Provider of Service, Patient"))
- E1018 =
t:: R.new(:E1018, "Exponent" , 1, 15)
- E1028 =
t::AN.new(:E1028, "Claim Submitter's Identifier" , 1, 38)
- E1029 =
t::ID.new(:E1029, "Claim Status Code" , 1, 2, s::CodeList.build( "1" => "Processed as Primary", "2" => "Processed as Secondary", "3" => "Processed as Tertiary", "4" => "Denied", "19" => "Processed as Primary, Forwarded to Additional Payer(s)", "20" => "Processed as Secondary, Forwarded to Additional Payer(s)", "21" => "Processed as Tertiary, Forwarded to Additional Payer(s)", "22" => "Reversal of Previous Payment", "23" => "Not Our Claim, Forwarded to Additional Payer(s)", "25" => "Predetermination Pricing Only - No Payment"))
- E1032 =
t::ID.new(:E1032, "Claim Filing Indicator Code" , 1, 2, s::CodeList.build( "11" => "Other Non-Federal Programs", "12" => "Preferred Provider Organization (PPO)", "13" => "Point of Service (POS)", "14" => "Exclusive Provider Organization (EPO)", "15" => "Indemnity Insurance", "16" => "Health Maintenance Organization (HMO) Medicare Risk", "17" => "Dentail Maintenance Organization", "AM" => "Automobile Medical", "BL" => "Blue Cross/Blue Shield", "CH" => "Champus", "CI" => "Commercial Insurance Co.", "DS" => "Disability", "FI" => "Federal Employees Program", "HM" => "Health Maintenance Organization", "LM" => "Liability Medical", "MA" => "Medicare Part A", "MB" => "Medicare Part B", "MC" => "Medicaid", "ME" => "Medicare Advantage Plan", "OF" => "Other Federal Program", "TV" => "Title V", "UK" => "Unknown", "VA" => "Veterans Affairs Plan", "WC" => "Worker's Compensation Health Claim", "ZZ" => "Mutually Defined"))
- E1033 =
t::ID.new(:E1033, "Claim Adjustment Group Code" , 1, 12, s::CodeList.build( "CO" => "Contractual Obligations", "CR" => "Corrections and Reversals", "OA" => "Other adjustments", "PI" => "Payor Initiated Reductions", "PR" => "Patient Responsibility"))
- E1034 =
t::ID.new(:E1034, "Claim Adjustment Reason Code" , 1, 5, s::CodeList.external("139"))
- E1035 =
t::AN.new(:E1035, "Name Last or Organization Name" , 1, 60)
- E1036 =
t::AN.new(:E1036, "Name First" , 1, 35)
- E1037 =
t::AN.new(:E1037, "Name Middle" , 1, 25)
- E1038 =
t::AN.new(:E1038, "Name Prefix" , 1, 10)
- E1039 =
t::AN.new(:E1039, "Name Suffix" , 1, 10)
- E1048 =
t::ID.new(:E1048, "Business Function Code" , 1, 3)
- E1065 =
t::ID.new(:E1065, "Entity Type Qualifier" , 1, 1, s::CodeList.build( "1" => "Person", "2" => "Non-Person Entity"))
- E1066 =
t::ID.new(:E1066, "Citizenship Status Code" , 1, 2)
- E1067 =
t::ID.new(:E1067, "Marital Status Code" , 1, 1, s::CodeList.build( "A" => "Common Law", "B" => "Registered Domestic Partner", "C" => "Not Applicable", "D" => "Divorced", "I" => "Single", "K" => "Unknown", "M" => "Married", "R" => "Unreported", "S" => "Separated", "U" => "Unmarried (Single or Divorced or Widowed)", "W" => "Widowed", "X" => "Legally Separated"))
- E1068 =
t::ID.new(:E1068, "Gender Code" , 1, 1, s::CodeList.build( "F" => "Female", "M" => "Male", "U" => "Unknown"))
- E1069 =
t::ID.new(:E1069, "Individual Relationship Code" , 2, 2, s::CodeList.build( "01" => "Spouse", "03" => "Father or Mother", "04" => "Grandfather or Grandmother", "05" => "Grandson or Granddaughter", "06" => "Uncle or Aunt", "07" => "Nephew or Niece", "08" => "Cousin", "09" => "Adopted Child", "10" => "Foster Child", "11" => "Son-in-law or Daughter-in-law", "12" => "Brother-in-law or Sister-in-law", "13" => "Mother-in-law or Father-in-law", "14" => "Brother or Sister", "15" => "Ward", "16" => "Stepparent", "17" => "Stepson or Stepdaughter", "18" => "Self", "19" => "Child", "20" => "Employee", "21" => "Unknown", "22" => "Handicapped Dependent", "23" => "Sponsored Dependent", "24" => "Dependent of a Minor Dependent", "25" => "Ex-spouse", "26" => "Guardian", "29" => "Signficant Other", "31" => "Court Appointed Guardian", "32" => "Mother", "33" => "Father", "34" => "Other Adult", "38" => "Collateral Dependent", "39" => "Organ Donor", "40" => "Cadaver Donor", "41" => "Injured Plaintiff", "43" => "Child Where Insured Has No Financial Responsibility", "53" => "Life Partner", "60" => "Annuitant", "D2" => "Trustee", "G8" => "Other Relationship", "G9" => "Other Relative"))
- E1073 =
t::ID.new(:E1073, "Yes/No Condition or Response Code" , 1, 1, s::CodeList.build( "N" => "No", "U" => "Unknown", "Y" => "Yes", "W" => "Not Applicable"))
- E1109 =
t::ID.new(:E1109, "Race or Ethnicity Code" , 1, 1)
- E1136 =
t::ID.new(:E1136, "Code Category" , 2, 2, s::CodeList.build( "07" => "Ambulance Certification", "09" => "Durable Medical Equipment Certification", "12" => "Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan", "13" => "Medicare Secondary End-Stage Renal Disease Beneficiary in Mandated Coordination Period with an Employer's Group Health Plan", "14" => "Medicare Secondary, No-fault Insurance including Auto is Primary", "15" => "Medicare Secondary Worker's Compensation", "16" => "Medicare Secondary Public Health Service (PHS) or Other Federal Agency", "41" => "Medicare Secondary Blank Lung", "42" => "Medicare Secondary Veteran's Administration", "43" => "Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP)", "44" => "Nature of Injury", "47" => "Medicare Secondary, Other Liability Insurance is Primary", "70" => "Hospice", "75" => "Functional Limitations", "E1" => "Spectacle Lenses", "E2" => "Contact Lenses", "E3" => "Spectacle Frames", "ZZ" => "Mutually Defined"))
- E1137 =
t::AN.new(:E1137, "Medical Code Value" , 1, 15)
- E1138 =
t::ID.new(:E1138, "Payer Responsibility Sequence" , 1, 1, s::CodeList.build( "P" => "Primary", "S" => "Secondary", "T" => "Tertiary", "U" => "Unknown", "A" => "Payer Responsibility Four", "B" => "Payer Responsibility Five", "C" => "Payer Responsibility Six", "D" => "Payer Responsibility Seven", "E" => "Payer Responsibility Eight", "F" => "Payer Responsibility Nine", "G" => "Payer Responsibility Ten", "H" => "Payer Responsibility Eleven", "N" => "Unconfirmed"))
- E1143 =
t::ID.new(:E1143, "Coordination of Benefits Code" , 1, 1, s::CodeList.build( "1" => "Coordination of Benefits", "5" => "Unknown", "6" => "No Coordination of Benefits"))
- E1146 =
t::ID.new(:E1146, "Disability Type Code" , 1, 1, s::CodeList.build( "1" => "Short Term Disability", "2" => "Long Term Disability", "3" => "Permanent or Total Disability", "4" => "No Disability"))
- E1149 =
t::ID.new(:E1149, "Occupation Code" , 4, 6)
- E1154 =
t::ID.new(:E1154, "Work Intensity Code" , 1, 1)
- E1161 =
t::ID.new(:E1161, "Product Option Code" , 1, 2)
- E1165 =
t::ID.new(:E1165, "Confidentiality Code" , 1, 1, s::CodeList.build( "R" => "Restricted Access", "U" => "Unrestricted Access"))
- E1166 =
t::ID.new(:E1166, "Contract Type Code" , 2, 2, s::CodeList.build( "01" => "Diagnosis Related Group (DRG)", "02" => "Per Diem", "03" => "Variable Per Diem", "04" => "Flat", "05" => "Captitated", "06" => "Percent", "09" => "Other"))
- E1167 =
t:: R.new(:E1167, "Sample Selection Modulus" , 1, 6)
- E1176 =
t::ID.new(:E1176, "Employment Class Code" , 2, 3, s::CodeList.build( "01" => "Union", "02" => "Non-Union", "03" => "Executive", "04" => "Non-Executive", "05" => "Management", "06" => "Non-Management", "07" => "Hourly", "08" => "Salaried", "09" => "Administrative", "10" => "Non-Administrative", "11" => "Exempt", "12" => "Non-Exempt", "17" => "Highly Compensated", "18" => "Key-Employee", "19" => "Bargaining", "20" => "Non-Bargaining", "21" => "Owner", "22" => "President", "23" => "Vice President"))
- E1201 =
t::ID.new(:E1201, "Information Status Code" , 1, 1, s::CodeList.build( "A" => "Partial", "C" => "Current", "L" => "Latest", "O" => "Oldest", "P" => "Prior", "S" => "Second Most Current", "T" => "Third Most Current"))
- E1203 =
t::ID.new(:E1203, "Maintenance Reason Code" , 2, 3, s::CodeList.build( "01" => "Divorce", "02" => "Birth", "03" => "Death", "04" => "Retirement", "05" => "Adoption", "06" => "Strike", "07" => "Termination of Benefits", "08" => "Termination of Employment", "09" => "Consolidation Omnibus Budget Reconciliation Act (COBRA)", "10" => "Consolidation Omnibus Budget Reconciliation Act (COBRA) Premium Paid", "11" => "Surviving Spouse", "14" => "Voluntary Withdrawal", "15" => "Primary Care Provider (PCP) Change", "16" => "Quit", "17" => "Fired", "18" => "Suspended", "20" => "Active", "21" => "Disability", "22" => "Plan Change", "25" => "Change in Identifying Data Elements", "26" => "Declined Coverage", "27" => "Pre-Enrollment", "28" => "Initial Enrollment", "29" => "Benefit Selection", "31" => "Legal Separation", "32" => "Marriage", "33" => "Personnel Data", "37" => "Leave of Absence with Benefits", "38" => "Leave of Absence without Benefits", "39" => "Lay Off with Benefits", "40" => "Lay Off without Benefits", "41" => "Re-enrollment", "43" => "Change of Location", "46" => "Current Customer Information File in Error", "59" => "Non Payment", "AA" => "Dissatisfaction with Office Staff", "AB" => "Dissatisfaction with Medical Care/Services Rendered", "AC" => "Inconvenient Office Location", "AD" => "Dissatisfaction with Office Hours", "AE" => "Unable to Schedule Appointments in a Timely Manner", "AF" => "Dissatisfaction with Physician's Referral Policy", "AG" => "Less Respect and Attention Time Given than to Other Patients", "AH" => "Patient Moved to a New Location", "AI" => "No Reason Given", "AJ" => "Appointment Times not Met in a Timely Manner", "AL" => "Algorithm Assigned Benefit Selection", "EC" => "Member Benefit Selection", "XN" => "Notification Only", "XT" => "Transfer"))
- E1204 =
t::AN.new(:E1204, "Plan Coverage Description" , 1, 50)
- E1205 =
t::ID.new(:E1205, "Insurance Line Code" , 2, 3, s::CodeList.build( "AG" => "Preventative Care/Wellness", "AH" => "24 Hour Care", "AJ" => "Medicare Risk", "AK" => "Mental Health", "DCP" => "Dental Capitation", "DEN" => "Dental", "EPO" => "Exclusive Provider Organization", "FAC" => "Facility", "HE" => "Hearing", "HLT" => "Health", "HMO" => "Health Maintenance Organization", "LTC" => "Long-Term Care", "LTD" => "Long-Term Disability", "MM" => "Major Medical", "MOD" => "Mail Order Drug", "PDG" => "Prescription Drug", "POS" => "Point of Service", "PPO" => "Preferred Provider Organization", "PRA" => "Practitioners", "STD" => "Short-Term Disability", "UR" => "Utilization Review", "VIS" => "Vision"))
- E1207 =
t::ID.new(:E1207, "Coverage Level Code" , 3, 3, s::CodeList.build( "CHD" => "Children Only", "DEP" => "Dependents Only", "E1D" => "Employee and One Dependent", "E2D" => "Employee and Two Dependents", "E3D" => "Employee and Three Dependents", "E5D" => "Employee and One or More Dependents", "E6D" => "Employee and Two or More Dependents", "E7D" => "Employee and Three or More Dependents", "E8D" => "Employee and Four or More Dependents", "E9D" => "Employee and Five or More Dependents", "ECH" => "Employee and Children", "EMP" => "Employee Only", "ESP" => "Employee and Spouse", "FAM" => "Family", "IND" => "Individual", "SPC" => "Spouse and Children", "SPO" => "Spouse Only", "TWO" => "Two Party"))
- E1209 =
t::ID.new(:E1209, "Underwriting Decision Code" , 1, 1)
- E1211 =
t::ID.new(:E1211, "Drug House Code" , 2, 3)
- E1212 =
t::ID.new(:E1212, "Health-Related Code" , 1, 1, s::CodeList.build( "N" => "None", "S" => "Substance Abuse", "T" => "Tobacco Use", "U" => "Unknown", "X" => "Tobacco Use and Substance Abuse"))
- E1213 =
t::ID.new(:E1213, "Current Health Condition Code" , 1, 1)
- E1214 =
t::AN.new(:E1214, "Salary Grade" , 1, 5)
- E1215 =
t::ID.new(:E1215, "Identification Card Type Code" , 1, 1, s::CodeList.build( "D" => "Dental Insurance", "H" => "Health Insurance", "P" => "Prescription Drug Service Drug Insurance"))
- E1216 =
t::ID.new(:E1216, "Benefit Status Code" , 1, 1, s::CodeList.build( "A" => "Active", "C" => "Consolidated Omnibus Budget Reconciliation Act (COBRA)", "S" => "Surviving Insured", "T" => "Tax Equity and Fiscal Responsibility Act (TEFRA)"))
- E1218 =
t::ID.new(:E1218, "Benefit Status Code" , 1, 1, s::CodeList.build( "A" => "Medicare Part A", "B" => "Medicare Part B", "C" => "Medicare Part A and B", "D" => "Medicare", "E" => "No Medicare", "F" => "Medicare Part D", "G" => "Medicare Part A and D", "H" => "Medicare Part B and D", "I" => "Medicare Part A, B, and D"))
- E1219 =
t::ID.new(:E1219, "Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying", 1, 2, s::CodeList.build( "1" => "Termination of Employment", "2" => "Reduction of work hours", "3" => "Medicare", "4" => "Death", "5" => "Divorce", "6" => "Separation", "7" => "Ineligible Child", "8" => "Bankruptcy of Retiree's Former Employer (26 U.S.C. 4980B(f)(3)(F))", "9" => "Layoff", "10" => "Leave of Absence", "ZZ" => "Mutually Defined"))
- E1220 =
t::ID.new(:E1220, "Student Status Code" , 1, 1, s::CodeList.build( "F" => "Full-time", "N" => "Not a Student", "P" => "Part-time"))
- E1221 =
t::ID.new(:E1221, "Provider Code" , 1, 3, s::CodeList.build( "AD" => "Admitting", "AS" => "Assistant Surgeon", "AT" => "Attending", "BI" => "Billing", "CO" => "Consulting", "CV" => "Covering", "H" => "Hospital", "HH" => "Home Health Care", "LA" => "Laboratory", "OP" => "Operating", "OR" => "Ordering", "OT" => "Other Physician", "P1" => "Pharmacist", "P2" => "Pharmacy", "PC" => "Primary Care Physician", "PE" => "Performing", "R" => "Rural Health Clinic", "RF" => "Referring", "SB" => "Submitting", "SK" => "Skilled Nursing Facility", "SU" => "Supervising"))
- E1222 =
t::AN.new(:E1222, "Provider Specialty Code" , 1, 3)
- E1223 =
Note:
Copied from an unverified source
t::ID.new(:E1223, "Provider Organization Code" , 3, 3)
- E1250 =
t::ID.new(:E1250, "Date Time Period Format Qualifier" , 2, 3, s::CodeList.build( "CC" => "First Two Digits of Year Expressed in Format CCYY", "CD" => "Month and Year Expressed in Format MMMYYY", "CM" => "Date in Format CCYYMM", "CQ" => "Date in Format CCYYQ", "CY" => "Year Expressed in Format CCYY", "D6" => "Date Expressed in Format YYMMDD", "D8" => "Date Expressed in Format CCYYMMDD", "DA" => "Range of Dates within a Single Month Expressed in Format DD-DD", "DB" => "Date Expressed in Format MMDDCCYY", "DD" => "Day of Month in Numeric Format", "DDT" => "Range of Dates and Time Expressed in Format CCYYMMDD-CCYYMMDDHHMM", "DT" => "Date and Time Expressed in Format CCYYMMDDHHMM", "DTD" => "Range of Dates and Time Expressed in Format CCYYMMDDHHMM-CCYYMMDD", "DTS" => "Range of Date and Time Expressed in Format CCYYMMDDHHMMSS-CCYYMMDDHHMMSS", "EH" => "Last Digit of Year and Julian Date Expressed in Format YDDD", "KA" => "Date Expressed in Format YYMMMDD", "MD" => "Month of Year and Day of Month Expressed in Format MMDD", "MM" => "Month of Year in Numeric Format", "RD" => "Range of Dates Expressed in Format MMDDCCYY-MMDDCCYY", "RD2" => "Range of Years Expressed in Format YY-YY", "RD4" => "Range of Years Expressed in Format CCYY-CCYY", "RD5" => "Range of Years and Months Expressed in Format CCYYMM-CCYYMM", "RD6" => "Range of Dates Expressed in Format YYMMDD-YYMMDD", "RD8" => "Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD", "RDM" => "Range of Dates Expressed in Format YYMMDD-MMDD", "RDT" => "Range of Date and Time Expressed in Format CCYYMMDDHHMM-CCYYMMDDHHMM", "RMD" => "Range of Months and Days Expressed in Format MMDD-MMDD", "RMY" => "Range of Years and Months Expressed in Format YYMM-YYMM", "RTM" => "Range of Time Expressed in Format HHMM-HHMM", "RTS" => "Date and Time Expressed in Format CCYYMMDDHHMMSS", "TC" => "Julian Date Expressed in Format DDD", "TM" => "Time Expressed in Format HHMM", "TQ" => "Date Expressed in Format MMYY", "TR" => "Date and Time Expressed in Format DDMMYYHHMM", "TS" => "Time Expressed in Format HHMMSS", "TT" => "Date Expressed in Format MMDDYY", "TU" => "Date EXpressed in Format YYDDD", "UN" => "Unstructured", "YM" => "Year and Month Expressed in Format YYMM", "YMM" => "Range of Year and Month Expressed in Format CCYYMM-MMM", "YY" => "Last Two Digits of Year Expressed in Format CCYY"))
- E1251 =
t::AN.new(:E1251, "Date Time Period" , 1, 35)
- E1270 =
t::ID.new(:E1270, "Code List Qualifier Code" , 1, 3, s::CodeList.build( "65" => s::CodeList.external("508"), "68" => s::CodeList.external("682"), "AAA" => s::CodeList.external("662"), "AAU" => s::CodeList.external("131"), "AAW" => s::CodeList.external("133"), "AAX" => s::CodeList.external("131"), "AAY" => s::CodeList.external("135"), "ABF" => s::CodeList.external("897"), "ABJ" => s::CodeList.external("897"), "ABK" => s::CodeList.external("897"), "ABN" => s::CodeList.external("897"), "ABU" => s::CodeList.external("897"), "ABV" => s::CodeList.external("897"), "ADD" => s::CodeList.external("897"), "APR" => s::CodeList.external("897"), "AS" => s::CodeList.external("656"), "ASD" => s::CodeList.external("897"), "ATD" => s::CodeList.external("897"), "CAH" => s::CodeList.external("843"), "BBQ" => s::CodeList.external("896"), "BBR" => s::CodeList.external("896"), "BE" => s::CodeList.external("132"), "BF" => s::CodeList.external("131"), "BG" => s::CodeList.external("132"), "BH" => s::CodeList.external("132"), "BI" => s::CodeList.external("132"), "BK" => s::CodeList.external("131"), "BJ" => s::CodeList.external("131"), "BN" => s::CodeList.external("131"), "BO" => s::CodeList.external("130"), "BP" => s::CodeList.external("130"), "BQ" => s::CodeList.external("131"), "BR" => s::CodeList.external("131"), "BT" => s::CodeList.external("407"), "BU" => s::CodeList.external("407"), "BUR" => s::CodeList.external("971"), "BS" => s::CodeList.external("133"), "DD" => s::CodeList.external("131"), "DR" => s::CodeList.external("229"), "EK" => s::CodeList.external("407"), "GR" => s::CodeList.external("284"), "GS" => s::CodeList.external("407"), "GU" => s::CodeList.external("407"), "GW" => s::CodeList.external("407"), "HE" => s::CodeList.external("411"), "HI" => s::CodeList.external("121"), "HO" => s::CodeList.external("537"), "JO" => s::CodeList.external("135"), "JP" => s::CodeList.external("135"), "LOI" => s::CodeList.external("663"), "NI" => s::CodeList.external("284"), # or s::CodeList.external("407") "NUB" => s::CodeList.external("132"), "NDC" => s::CodeList.external("240"), "PR" => s::CodeList.external("131"), "PB" => s::CodeList.external("407"), "REC" => s::CodeList.external("860"), "RET" => s::CodeList.external("859"), "RM" => s::CodeList.external("973"), "RX" => s::CodeList.external("530"), "S" => s::CodeList.external("327"), "SD" => s::CodeList.external("131"), "SJ" => s::CodeList.external("407"), "SL" => s::CodeList.external("407"), "TC" => s::CodeList.external("359"), "TD" => s::CodeList.external("131"), "TQ" => s::CodeList.external("135"), "UT" => s::CodeList.external("528"), "ZZ" => "Mutually Defined"))
- E1271 =
t::AN.new(:E1271, "Industry Code" , 1, 30, s::CodeList.external("508"))
- E1330 =
t::ID.new(:E1330, "Dosage Form Code" , 2, 3, s::CodeList.build( "10" => "Tablet", "20" => "Capsule", "30" => "Lozenge or Troche", "31" => "Internal Powder", "43" => "Injectable Lyophilized Powder", "60" => "Elixir", "61" => "Suspension", "62" => "Syrup", "63" => "Solution", "64" => "Emulsion", "67" => "Liquid", "69" => "Rectal Cream or Ointment", "70" => "Rectal Suppository", "71" => "Vaginal Suppository", "73" => "Vaginal Cream", "75" => "Urethral Suppository", "76" => "Enema", "78" => "Vaginal Ointment", "80" => "External Ointment", "81" => "External Cream", "86" => "External Powder"))
- E1303 =
t::ID.new(:E1303, "Use of Language Indicator" , 1, 2, s::CodeList.build( "5" => "Language Reading", "6" => "Language Writing", "7" => "Language Speaking", "8" => "Native Language"))
- E1314 =
t::ID.new(:E1314, "Admission Source Code" , 1, 1, s::CodeList.external("230"))
- E1315 =
t::ID.new(:E1315, "Admission Type Code" , 1, 1, s::CodeList.external("231"))
- E1316 =
t::ID.new(:E1316, "Ambulance Transport Code" , 1, 1, s::CodeList.build( "I" => "Initial Trip", "R" => "Return Trip", "T" => "Transfer Trip", "X" => "Round Trip"))
- E1317 =
t::ID.new(:E1317, "Ambulance Transport Reason Code" , 1, 1, s::CodeList.build( "A" => "Patient was transported to nearest facility for care of symptoms, complaints, or both", "B" => "Patient was transported for the benefit of a preferred physician", "C" => "Patient was transported for the nearness of family members", "D" => "Patient was transported for the care of a specialist or for availability of specialized equipment", "E" => "Patient Transferred to Rehabilitation Facility"))
- E1321 =
t::ID.new(:E1321, "Condition Indicator" , 2, 3, s::CodeList.build( "00" => "Patient was transported in an emergency situation", "01" => "Patient was admitted to a hospital", "02" => "Patient was bed confined before the ambulance service", "03" => "Patient was bed confined after the ambulance service", "04" => "Patient was moved by stretcher", "05" => "Patient was unconscious or in shock", "06" => "Patient was transported in an emergency situation", "07" => "Patient had to be physically restrained", "08" => "Patient had visible hemorrhaging", "09" => "Ambulance service was medically necessary", "10" => "Patient is ambulatory", "11" => "Ambulation is Impaired and Walking Aid is Used for Therapy or Mobility", "12" => "Patient is confined to a bed or chair", "14" => "Ambulation is Impaired and Walking Aid is Used for Mobility", "15" => "Patient Condition Requires Positioning of the Body or Attachments Which Would Not be Feasible With the Use of an Ordinary Bed", "16" => "Patient needs a trapeze bar to sit up due to respiratory condition or change body positions for other medical reasons", "17" => "Patient's Ability to Breathe is Severely Impaired", "18" => "Patient condition requires frequent and/or immediate changes in body positions", "19" => "Patient can operate controls", "20" => "Siderails Are to be Attached to a Hospital Bed Owned by the Beneficiary", "21" => "Patient owns equipment", "22" => "Mattress or Siderails are Being Used with Prescribed Medically Necessary Hospital Bed Owned by the Beneficiary", "23" => "Patient Needs Lift to Get In or Out of Bed or to Assist in Transfer from Bed to Wheelchair", "24" => "Patient has an orthopedic impairment requiring traction equipment which prevents ambulation during period of use", "25" => "Item has been prescribed as part of a planned regimen of treatment in patient home", "27" => "Patient or a care-giver has been instructed in use of equipment", "29" => "A 6-7 hour nocturnal study documents 30 episodes of apnea each lasting more than 10 seconds", "30" => "Without the equipment, the patient would require surgery", "31" => "Patient has had a total knee replacement", "32" => "Patient has intractable lymphedema of the extremities", "33" => "Patient is in a nursing home", "35" => "This Feeding is the Only Form of Nutritional Intake for This Patient", "37" => "Oxygen delivery equipment is stationary", "38" => "Certification signed by the physician is on file at the supplier's office", "39" => "Patient Has Mobilizing Respiratory Tract Secretions", "40" => "Patient or Caregiver is Capable of Using the Equipment Without Technical or Professional Supervision", "41" => "Patient or Caregiver is Unable to Propel or Lift a Standard Weight Wheelchair", "42" => "Patient Requires Leg Elevation for Edema or Body Alignment", "43" => "Patient Weight or Usage Needs Necessitate a Heavy Duty Wheelchair", "44" => "Patient Requires Reclining Function of a Wheelchair", "45" => "Patient is Unable to Operate a Wheelchair Manually", "46" => "Patient or Caregiver Requires Side Transfer into Wheelchair, Commode or Other", "58" => "Durable Medical Equipment (DME) Purchased New", "59" => "Durable Medical Equipment (DME) Is Under Warranty", "5A" => "Treatment is rendered related to the terminal illness", "5P" => "Replacement", "60" => "Transportation Was To the Nearest Facility", "65" => "Open", "68" => "Severe", "69" => "Moderate", "9D" => "Lack of Appropriate Facility within Reasonable Distance to Treat Patient in the Event of Complications", "9E" => "Sudden Onset of Disorientation", "9F" => "Sudden Onset of Severe, Incapacitating Pain", "9H" => "Patient Requires Intensive IV Therapy", "9J" => "Patient Requires Protective Isolation", "9K" => "Patient Requires Frequent Monitoring", "AA" => "Amputation", "AL" => "Ambulation Limitations", "ATR" => "Atrophy", "AV" => "Available - Not Used", "BL" => "Bowel Limitations, Bladder Limitations, or both (Incontinence)", "BPD" => "Beneficiary is Partially Dependent", "BTD" => "Beneficiary is Totally Dependent", "BR" => "Bedrest BRP (Bathroom Privileges)", "CA" => "Cane Required", "CB" => "Complete Bedrest", "CM" => "Comatose", "CNJ" => "Cumulative Injury", "CO" => "Contracture", "CR" => "Crutches Required", "DX" => "Unable to Respond", "DY" => "Dyspnea with Minimal Exertion", "EL" => "Endurance Limitations", "EP" => "Exercises Prescribed", "F3" => "Inactive", "HL" => "Hearing Limitations", "IH" => "Independent at Home", "L1" => "General Standard of 20 Degree or .5 Diopter Sphere or Cylinder Change Met", "L2" => "Replacement Due to Loss or Theft", "L3" => "Replacement Due to Breakage or Damage", "L4" => "Replacement Due to Patient Preference", "L5" => "Replacement Due to Medical Reason", "LB" => "Legally Blind", "LE" => "Lethargic", "NU" => "Not Used", "NR" => "No Restrictions", "OL" => "Other Limitation", "PA" => "Paralysis", "PAR" => "Paraplegia", "PW" => "Partial Weight Bearing", "S2" => "Under Treatment", "S9" => "Atypical Functional Condition", "SL" => "Speech Limitations", "ST" => "New Services Requested", "TNJ" =>"Traumatic Injury", "TR" => "Transfer to Bed, or Chair, or Both", "UT" => "Up as Tolerated", "WA" => "Walker Required", "WR" => "Wheelchair Required", "ZV" => "Replacement Item"))
- E1322 =
t::ID.new(:E1322, "Certification Type Code" , 1, 1, s::CodeList.build( "1" => "Appeal - Immediate", "2" => "Appeal - Standard", "3" => "Cancel", "4" => "Extension", "I" => "Initial", "N" => "Reconsideration", "R" => "Renewal", "S" => "Revised"))
- E1325 =
t::ID.new(:E1325, "Claim Frequency Type Code" , 1, 1, s::CodeList.external("235"))
- E1327 =
t::ID.new(:E1327, "Copay Status Code" , 1, 1, s::CodeList.build( "0" => "Copay exempt"))
- E1328 =
t::Nn.new(:E1328, "Diagnosis Code Pointer" , 1, 2, 0)
- E1331 =
t::AN.new(:E1331, "Facility Code Value" , 1, 2)
- E1332 =
S237
t::ID.new(:E1332, "Facility Code Qualifier" , 1, 2, s::CodeList.build( "A" => s::CodeList.external("236"), "B" => s::CodeList.external("237")))
- E1333 =
t::ID.new(:E1333, "Record Format Code" , 1, 2)
- E1334 =
t::ID.new(:E1334, "Professional Shortage Area Code" , 1, 1)
- E1335 =
t::ID.new(:E1335, "Insulin Type Code" , 1, 3)
- E1336 =
t::ID.new(:E1336, "Insurance Type Code" , 1, 3, s::CodeList.build( "02" => "Physically Handicapped Children's Program", "03" => "Special Federal Funding", "05" => "Disability", "09" => "Second Opinion or Surgery", "12" => "Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan", "13" => "Medicare Secondary End-Stage Renal Disease Beneficiary in the Mandated Coordination Period", "14" => "Medicare Secondary, No-fault Insurance including Auto is Primary", "15" => "Medicare Secondary Worker's Compensation", "16" => "Medicare Secondary Public Health Service (PHS) or Other Federal Agency", "41" => "Medicare Secondary Blank Lung", "42" => "Medicare Secondary Veteran's Administration", "43" => "Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP)", "47" => "Medicare Secondary, Other Liability Insurance is Primary", "AP" => "Auto Insurance Policy", "C1" => "Commercial", "CO" => "Consolidated Omnibus Budget Reconciliation Act (COBRA)", "CP" => "Medicare Conditionally Primary", "D" => "Disability", "DB" => "Disability Benefits", "EP" => "Exclusive Provider Organization", "FF" => "Family or Friends", "GP" => "Group Policy", "HM" => "Health Maintenance Organization (HMO)", "HN" => "Health Maintenance Organization (HMO) - Medicare Risk", "HS" => "Special Low Income Medicare Beneficiary", "IN" => "Indemnity", "IP" => "Individual Policy", "LC" => "Long Term Care", "LD" => "Long Term Policy", "LI" => "Life Insurance", "LT" => "Litigation", "MA" => "Medicare Part A", "MB" => "Medicare Part B", "MC" => "Medicaid", "MH" => "Medigap Part A", "MI" => "Medigap Part B", "MP" => "Medicare Primary", "OT" => "Other", "PE" => "Property Insurance - Personal", "PL" => "Personal", "PP" => "Personal Payment (Cash - No Insurance)", "PR" => "Preferred Provider Organization (PPO)", "PS" => "Point of Service (POS)", "QM" => "Qualified Medicare Beneficiary", "RP" => "Property Insurance - Real", "SP" => "Supplemental Policy", "TF" => "Tax Equity Fiscal Responsibility Act (TEFRA)", "WC" => "Workers Compensation", "WU" => "Wrap Up Policy"))
- E1337 =
t::ID.new(:E1337, "Level of Care Code" , 1, 1, s::CodeList.build( "1" => "Skilled Nursing Facility (SNF)", "2" => "Intermediate Care Facility (ICF)", "3" => "Intermediate Care Facility - Mentally Retarded (ICF-MR)", "4" => "Chronic Disease Hospital (CD)", "5" => "Intermediate Care Facility (ICF) Level II", "6" => "Special Skilled Nursing Facility (SNF)", "7" => "Nursing Facility (NF)", "8" => "Hospice"))
- E1338 =
t::ID.new(:E1338, "Level of Service Code" , 1, 3)
- E1339 =
t::AN.new(:E1339, "Procedure Modifier" , 2, 2)
- E1340 =
t::ID.new(:E1340, "Multiple Procedure Code" , 1, 2)
- E1341 =
t::AN.new(:E1341, "National or Local Assigned Review" , 1, 2)
- E1342 =
t::ID.new(:E1342, "Nature of Condition Code" , 1, 1, s::CodeList.build( "A" => "Acute Condition", "C" => "Chronic Condition", "D" => "Non-acute", "E" => "Non-Life Threatening", "F" => "Routine", "G" => "Symptomatic", "M" => "Acute Manifestation of a Chronic Condition"))
- E1343 =
t::ID.new(:E1343, "Non-Institutional Claim Type Code" , 1, 2)
- E1345 =
t::ID.new(:E1345, "Nursing Home Residential Status Code" , 1, 1)
- E1348 =
t::ID.new(:E1348, "Oxygen Equipment Type Code" , 1, 1, s::CodeList.build( "A" => "Concentrator", "B" => "Liquid Stationary", "C" => "Gaseous Stationary", "D" => "Liquid Portable", "E" => "Gaseous Portable", "O" => "Other"))
- E1351 =
t::ID.new(:E1351, "Patient Signature Source Code" , 1, 1, s::CodeList.build( "P" => "Signature generated by provider because the patient was not physically present for services"))
- E1352 =
t::ID.new(:E1352, "Patient Status Code" , 1, 2, s::CodeList.external("239"))
- E1354 =
t::ID.new(:E1354, "Diagnosis Related Group (DRG) Code" , 1, 4, s::CodeList.external("229"))
- E1358 =
t::ID.new(:E1358, "Prosthesis, Crown, or Inlay Code" , 1, 1, s::CodeList.build( "I" => "Initial Placement", "R" => "Replacement"))
- E1359 =
t::ID.new(:E1359, "Provider Accept Assignment Code" , 1, 1, s::CodeList.build( "A" => "Assigned", "B" => "Assigned Accepted on Clinical Lab Services Only", "C" => "Not Assigned"))
- E1360 =
t::ID.new(:E1360, "Provider Agreement Code" , 1, 1)
- E1361 =
t::ID.new(:E1361, "Oral Cavity Designation Code" , 1, 3, s::CodeList.external("135"))
- E1362 =
t::ID.new(:E1362, "Related-Causes Code" , 2, 3, s::CodeList.build( "AA" => "Auto Accident", "EM" => "Employment", "OA" => "Other Accident"))
- E1363 =
t::ID.new(:E1363, "Release of Information Code" , 1, 1, s::CodeList.build( "I" => "Informed Consent to Release Medical Information for Conditions or Diagnoses Regulated by Federal Statutes", "Y" => "Yes, Provider has a Signed Statement Permitting Release of Medical Billing Data Related to a Claim"))
- E1364 =
t::ID.new(:E1364, "Review Code" , 1, 2)
- E1365 =
t::ID.new(:E1365, "Service Type Code" , 1, 2, s::CodeList.build( "1" => "Medical Care", "2" => "Surgical", "3" => "Consultation", "4" => "Diagnostic X-Ray", "5" => "Diagnostic Lab", "6" => "Radiation Therapy", "7" => "Anesthesia", "8" => "Surgical Assistance", "9" => "Other Medical", "10" => "Blood Charges", "11" => "Used Durable Medical Equipment", "12" => "Durable Medical Equipment Purchase", "13" => "Ambulatory Service Center Facility", "14" => "Renal Supplies in the Home", "15" => "Alternate Method Dialysis", "16" => "Chronic Renal Disease (CRD) Equipment", "17" => "Pre-Admission Testing", "18" => "Durable Medical Equipment Rental", "19" => "Pneumonia Vaccine", "20" => "Second Surgical Opinion", "21" => "Third Surgical Opinion", "22" => "Social Work", "23" => "Diagnostic Dental", "24" => "Periodontics", "25" => "Restorative", "26" => "Endodontics", "27" => "Maxillofacial Prosthetics", "28" => "Adjunctive Dental Services", "30" => "Health Benefit Plan Coverage", "32" => "Plan Waiting Period", "33" => "Chiropractic", "34" => "Chiropractic Office Visits", "35" => "Dental Care", "36" => "Dental Crowns", "37" => "Dental Accident", "38" => "Orthodontics", "39" => "Prosthodontics", "40" => "Oral Surgery", "41" => "Routine (Preventive) Dental", "42" => "Home Health Care", "43" => "Home Health Prescriptions", "44" => "Home Health Visits", "45" => "Hospice", "46" => "Respite Care", "47" => "Hospital", "48" => "Hospital - Inpatient", "49" => "Hospital - Room and Board", "50" => "Hospital - Outpatient", "51" => "Hospital - Emergency Accident", "52" => "Hospital - Emergency Medical", "53" => "Hospital - Ambulatory Surgical", "54" => "Long Term Care", "55" => "Major Medical", "56" => "Medically Related Transportation", "57" => "Air Transportation", "58" => "Cabulance", "59" => "Licensed Ambulance", "60" => "General Benefits", "61" => "In-vitro Fertilization", "62" => "MRI/CAT Scan", "63" => "Donor Procedures", "64" => "Acupuncture", "65" => "Newborn Care", "66" => "Pathology", "67" => "Smoking Cessation", "68" => "Well Baby Care", "69" => "Maternity", "70" => "Transplants", "71" => "Audiology Exam", "72" => "Inhalation Therapy", "73" => "Diagnostic Medical", "74" => "Private Duty Nursing", "75" => "Prosthetic Device", "76" => "Dialysis", "77" => "Otological Exam", "78" => "Chemotherapy", "79" => "Allergy Testing", "80" => "Immunizations", "AN" => "Routine Exam", "AO" => "Lenses", "AQ" => "Nonmedically Necessary Physical", "AR" => "Experimental Drug Therapy", "B1" => "Burn Care", "B2" => "Brand Name Prescription Drug - Formulary", "B3" => "Brand Name Prescription Drug - Non-Formulary", "BA" => "Independent Medical Evaluation", "BB" => "Partial Hospitalization (Psychiatric)", "BC" => "Day Care (Psychiatric)", "BD" => "Cognitive Therapy", "BE" => "Massage Therapy", "BF" => "Pulmonary Rehabilitation", "BG" => "Cardiac Rehabilitation", "BH" => "Pediatric", "BI" => "Nursery", "BJ" => "Skin", "BK" => "Orthopedic", "BL" => "Cardiac", "BM" => "Lymphatic", "BN" => "Gastrointestinal", "BP" => "Endocrine", "BQ" => "Neurology", "BR" => "Eye", "BS" => "Invasive Procedures", "BT" => "Gynecological", "BU" => "Obstetrical", "BV" => "Obstetrical/Gynecological", "BW" => "Mail Order Prescription Drug: Brand Name", "BX" => "Mail Order Prescription Drug: Generic", "BY" => "Physician Visit - Office: Sick", "BZ" => "Physician Visit - Office: Well", "C1" => "Coronary Care", "CA" => "Private Duty Nursing - Inpatient", "CB" => "Private Duty Nursing - Home", "CC" => "Surgical Benefits - Professional (Physician)", "CD" => "Surgical Benefits - Facility", "CE" => "Mental Health Provider - Inpatient", "CF" => "Mental Health Provider - Outpatient", "CG" => "Mental Health Facility - Inpatient", "CH" => "Mental Health Facility - Outpatient", "CI" => "Substance Abuse Facility - Inpatient", "CJ" => "Substance Abuse Facility - Outpatient", "81" => "Routine Physical", "82" => "Family Planning", "83" => "Infertility", "84" => "Abortion", "85" => "AIDS", "86" => "Emergency Services", "87" => "Cancer", "88" => "Pharmacy", "89" => "Free Standing Prescription Drug", "90" => "Mail Order Prescription Drug", "91" => "Brand Name Prescription Drug", "92" => "Generic Prescription Drug", "93" => "Podiatry", "94" => "Podiatry - Office Visits", "95" => "Podiatry - Nursing Home Visits", "96" => "Professional (Physician)", "97" => "Anesthesiologist", "98" => "Professional (Physician) Visit - Office", "99" => "Professional (Physician) Visit - Inpatient", "A0" => "Professional (Physician) Visit - Outpatient", "A1" => "Professional (Physician) Visit - Nursing Home", "A2" => "Professional (Physician) Visit - Skilled Nursing Facility", "A3" => "Professional (Physician) Visit - Home", "A4" => "Psychiatric", "A5" => "Psychiatric - Room and Board", "A6" => "Psychotherapy", "A7" => "Psychiatric - Inpatient", "A8" => "Psychiatric - Outpatient", "A9" => "Rehabilitation", "AA" => "Rehabilitation - Room and Board", "AB" => "Rehabilitation - Inpatient", "AC" => "Rehabilitation - Outpatient", "AD" => "Occupational Therapy", "AE" => "Physical Medicine", "AF" => "Speech Therapy", "AG" => "Skilled Nursing Care", "AH" => "Skilled Nursing Care - Room and Board", "AI" => "Substance Abuse", "AJ" => "Alcoholism", "AK" => "Drug Addiction", "AL" => "Vision (Optometry)", "AM" => "Frames", "CK" => "Screening X-ray", "CL" => "Screening laboratory", "CM" => "Mammogram, High Risk Patient", "CN" => "Mammogram, Low Risk Patient", "CO" => "Flu Vaccination", "CP" => "Eyewear and Eyewear Accessories", "CQ" => "Case Management", "DG" => "Dermatology", "DM" => "Durable Medical Equipment", "DS" => "Diabetic Supplies", "GF" => "Generic Prescription Drug - Formulary", "GN" => "Generic Prescription Drug - Non-Formulary", "GY" => "Allergy", "IC" => "Intensive Care", "MH" => "Mental Health", "NI" => "Neonatal Intensive Care", "ON" => "Oncology", "PT" => "Physical Therapy", "PU" => "Pulmonary", "RN" => "Renal", "RT" => "Residential Psychiatric Treatment", "TC" => "Transitional Care", "TN" => "Transitional Nursery Care", "UC" => "Urgent Care"))
- E1366 =
t::ID.new(:E1366, "Special Program Code" , 2, 3, s::CodeList.build( "01" => "Early & Periodic Screening, Diagnosis, and Treatment (EPSDT) or Child Health Assessment Program (CHAP)", "02" => "Physically Handicapped Children's Program", "03" => "Special Federal Funding", "05" => "Disability", "09" => "Second Opinion or Surgery"))
- E1367 =
t::ID.new(:E1367, "Sublaxation Level Code" , 2, 3, s::CodeList.build( "C1" => "Cervical 1", "C2" => "Cervical 2", "C3" => "Cervical 3", "C4" => "Cervical 4", "C5" => "Cervical 5", "C6" => "Cervical 6", "C7" => "Cervical 7", "CO" => "Coccyx", "IL" => "Ilium", "L1" => "Lumbar 1", "L2" => "Lumbar 2", "L3" => "Lumbar 3", "L4" => "Lumbar 4", "OC" => "Occiput", "SA" => "Sacrum", "T1" => "Thoracic 1", "T10" => "Thoracic 10", "T11" => "Thoracic 11", "T12" => "Thoracic 12", "T2" => "Thoracic 2", "T3" => "Thoracic 3", "T4" => "Thoracic 4", "T5" => "Thoracic 5", "T6" => "Thoracic 6", "T7" => "Thoracic 7", "T8" => "Thoracic 8", "T9" => "Thoracic 9"))
- E1368 =
t::ID.new(:E1368, "Tooth Status Code" , 1, 2, s::CodeList.build( "E" => "To Be Extracted", "I" => "Impacted", "M" => "Missing", "X" => "Extracted"))
- E1369 =
t::ID.new(:E1369, "Tooth Surface Code" , 1, 2, s::CodeList.build( "B" => "Buccal", "D" => "Distal", "F" => "Facial", "I" => "Incisal", "L" => "Lingual", "M" => "Mesial", "O" => "Occlusal"))
- E1371 =
t:: R.new(:E1371, "Unit Rate" , 1, 10)
- E1382 =
t::ID.new(:E1382, "Oxygen Delivery System Code" , 1, 1, s::CodeList.build( "A" => "Nasal Cannula", "B" => "Oxygen Conserving Device", "C" => "Oxygen Conserving Device with Oxygen Pulse System", "D" => "Oxygen Conserving Device with Resevoir System", "E" => "Transtrachael Catheter"))
- E1383 =
t::ID.new(:E1383, "Claim Submission Reason Code" , 2, 2, s::CodeList.build( "08" => "@todo", "PB" => "Predetermination of Dental Benefits"))
- E1384 =
t::ID.new(:E1384, "Patient Location Code" , 1, 1)
- E1390 =
t::ID.new(:E1390, "Eligibility or Benefit Information Code", 1, 2, s::CodeList.build( "1" => "Active Coverage", "2" => "Active - Full Risk Capitation", "3" => "Active - Services Capitated", "4" => "Active - Services Capitated to Primary Care Physician", "5" => "Active - Pending Investigation", "6" => "Inactive", "7" => "Inactive - Pending Eligibility Update", "8" => "Inactive - Pending Investigation", "A" => "Co-Insurance", "B" => "Co-Payment", "C" => "Deductible", "CB" => "Coverage Basis", "D" => "Benefit Description", "E" => "Exclusions", "F" => "Limitations", "G" => "Out of Pocket (Stop Loss)", "H" => "Unlimited", "I" => "Non-Covered", "J" => "Cost Containment", "K" => "Reserve", "L" => "Primary Care Provider", "M" => "Pre-existing Condition", "MC" => "Managed Care Coordinator", "N" => "Services Restricted to Following Provider", "O" => "Not Deemed a Medical Necessity", "P" => "Benefit Disclaimer", "Q" => "Second Surgical Opinion Required", "R" => "Other or Additional Payor", "S" => "Prior Year(s) History", "T" => "Card(s) Reported Lost/Stolen", "U" => "Contact Following Entity for Eligibility or Benefit Information", "V" => "Cannot Process", "W" => "Other Source of Data", "X" => "Health Care Facility", "Y" => "Spend Down"))
- E1403 =
t::ID.new(:E1403, "Implant Type Code" , 1, 1, s::CodeList.build( "1" => "Pulse Generator", "2" => "Arterial Lead", "3" => "Ventricular Lead", "4" => "Implantable Cardioverter Defibrillator (ICDs)", "5" => "Implantable Cardiac Pacemaker (ICPs)", "6" => "Cardiac Resynchronization Therapy Devices (CRTs)", "7" => "Pacing Leads", "8" => "Pacing Battery", "9" => "Coronary Stent", "A" => "Peripheral Stent", "B" => "Heart Valve", "C" => "Ventricular-Assist Device", "D" => "Implantable Heart Monitor", "E" => "Knee", "F" => "Hip", "G" => "Shoulder", "H" => "Elbow", "I" => "Ankle", "J" => "Toe", "K" => "Finger", "L" => "Spinal", "M" => "Orthobiologic", "N" => "Tissue", "O" => "Facial", "P" => "Dental", "Q" => "Opthalmic", "R" => "Gynecologic", "S" => "Urogynecologic", "T" => "Drug", "U" => "Otolaryngeal", "V" => "Cochlear", "W" => "Cosmetic", "X" => "Gastroenterologic", "Y" => "Urologic", "Z" => "Other"))
- E1401 =
t::ID.new(:E1401, "Implant Status Code" , 1, 1, s::CodeList.build( "1" => "Implanted", "2" => "Explanted"))
- E1470 =
t::Nn.new(:E1470, "Number" , 1, 9, 0)
- E1473 =
t::ID.new(:E1473, "Pricing Methodology" , 2, 2, s::CodeList.build( "00" => "Zero Pricing (Not Covered Under Contract)", "01" => "Priced as Billed at 100%", "02" => "Priced at the Standard Fee Schedule", "03" => "Priced at a Contractual Percentage", "04" => "Bundled Pricing", "05" => "Peer Review Pricing", "06" => "Per Diem Pricing", "07" => "Flat Rate Pricing", "08" => "Combination Pricing", "09" => "Maternity Pricing", "10" => "Other Pricing", "11" => "Lower of Cost", "12" => "Ratio of Cost", "13" => "Cost Reimbursed", "14" => "Adjustment Pricing"))
- E1476 =
t::ID.new(:E1476, "Language Proficiency Indicator" , 1, 1)
- E1514 =
t::ID.new(:E1514, "Delay Reason Code" , 1, 2, s::CodeList.build( "1" => "Proof of Eligibility Unknown or Unavailable", "2" => "Litigation", "3" => "Authorization Delays", "4" => "Delay in Certifying Provider", "5" => "Delay in Shipping Billing Forms", "6" => "Delay in Delivery of Custom-made Appliances", "7" => "Third Party Processing Delay", "8" => "Delay in Eligibility Determination", "9" => "Original Claim Rejected or Denied Due to a Reason Unrelated to the Billing Limitation Rules", "10" => "Administration Delay in the Prior Approval Process", "11" => "Other", "15" => "Natural Disaster"))
- E1525 =
t::ID.new(:E1525, "Request Category Code" , 1, 2, s::CodeList.build( "AR" => "Admission Review", "HS" => "Health Services Review", "IN" => "Individual", "SC" => "Specialty Care Review"))
- E1526 =
t::ID.new(:E1526, "Policy Compliance Code" , 1, 2, s::CodeList.build( "1" => "Procedure Followed (Compliance)", "2" => "Not Followed - Call Not Made (Non-Compliance Call Not Made)", "3" => "Not Medically Necessary (Non-Compliance Non-Medically Necessary)", "4" => "Not Followed Other (Non-Compliance Other)", "5" => "Emergency Admit to Non-Network Hospital"))
- E1527 =
t::ID.new(:E1527, "Exception Code" , 1, 2, s::CodeList.build( "1" => "Non-Network Professional Provider in Network Hospital", "2" => "Emergency Care", "3" => "Services or Specialist not in Network", "4" => "Out-of-Service Area", "5" => "State Mandates", "6" => "Other"))
- E1528 =
t::Nn.new(:E1528, "Component Data Element Position in Composite", 1, 2, 0)
- E1595 =
t::ID.new(:E1595, "Government Service Affilition Code" , 1, 1, s::CodeList.build( "A" => "Air Force", "B" => "Air Force Reserves", "C" => "Army", "D" => "Army Reserves", "E" => "Coast Guard", "F" => "Marine Corps", "G" => "Marine Corps Reserves", "H" => "National Guard", "I" => "Navy", "J" => "Navy Reserves", "K" => "Other", "L" => "Peace Corp", "M" => "Regular Armed Forces", "N" => "Reserves", "O" => "U.S. Public Health Service", "Q" => "Foreign Military", "R" => "American Red Cross", "S" => "Department of Defense", "U" => "United Services Organization", "W" => "Military Sealift Command"))
- E1596 =
t::ID.new(:E1596, "Military Service Rank" , 1, 1, s::CodeList.build( "A1" => "Admiral", "A2" => "Airman", "A3" => "Airman First Class", "B1" => "Basic Airman", "B2" => "Brigadier General", "C1" => "Captain", "C2" => "Chief Master Sergeant", "C3" => "Chief Petty Officer", "C4" => "Chief Warrant", "C5" => "Colonel", "C6" => "Commander", "C7" => "Commodore", "C8" => "Corporal", "C9" => "Corporal Specialist 4", "E1" => "Ensign", "F1" => "First Lieutenant", "F2" => "First Sergeant", "F3" => "First Sergeant-Master Sergeant", "F4" => "Fleet Admiral", "G1" => "General", "G4" => "Gunnery Sergeant", "L1" => "Lance Corporal", "L2" => "Lieutenant", "L3" => "Lieutenant Colonel", "L4" => "Lieutenant Commander", "L5" => "Lieutenant General", "L6" => "Lieutenant Junior Grade", "M1" => "Major", "M2" => "Major General", "M3" => "Master Chief Petty Officer", "M4" => "Master Gunnery Sergeant Major", "M5" => "Master Sergeant", "M6" => "Master Sergeant Specialist 8", "P1" => "Petty Officer First Class", "P2" => "Petty Officer Second Class", "P3" => "Petty Officer Third Class", "P4" => "Private", "P5" => "Private First Class", "R1" => "Rear Admiral", "R2" => "Recruit", "S1" => "Seaman", "S2" => "Seaman Apprentice", "S3" => "Seaman Recruit", "S4" => "Second Lieutenant", "S5" => "Senior Chief Petty Officer", "S6" => "Senior Master Sergeant", "S7" => "Sergeant", "S8" => "Sergeant First Class Specialist 7", "S9" => "Sergeant Major Specialist 9", "SA" => "Sergeant Specialist 5", "SB" => "Staff Sergeant", "SC" => "Staff Sergeant Specialist 6", "T1" => "Technical Sergeant", "V1" => "Vice Admiral", "W1" => "Warrant Officer"))
- E1686 =
t::Nn.new(:E1686, "Repeating Data Element Position" , 1, 4, 0)
- E1701 =
t::ID.new(:E1701, "Eligibility Reason Code" , 1, 1, s::CodeList.build( "0" => "Age", "1" => "Disability", "2" => "End Stage Renal Disease (ESRD)"))
- E1705 =
t::AN.new(:E1705, "Implementation Convention Reference" , 1, 35)
- E1715 =
t::ID.new(:E1715, "Country Subdivision Code" , 1, 3, s::CodeList.external("5"))
- E9998 =
E1773 = t::ID.new(:E1774, “Claim Authorization Code” , 1, 2,
s::CodeList.build( "1" => "Immediate/Urgent Care", "2" => "Services Rendered in a Retroactive Period", "3" => "Emergency Care", "4" => "Client Has Temporary Medicaid", "5" => "Request from County for Second Opinion to Determine if Recipient Can Work", "6" => "Request for Override Pending", "7" => "Special Handling", "Z" => "Mutually Defined")) t::AN.new(:E9998, "Context Reference" , 1, 35)
- E9999 =
t::AN.new(:E9999, "Context Name" , 1, 35)
- C001 =
Schema::CompositeElementDef.build(:C001, "Composite Unit of Measure", "To identify a composite unit of measure", E355 .component_use(r::Mandatory), E1018.component_use(r::Optional), E649 .component_use(r::Optional), E355 .component_use(r::Optional), E1018.component_use(r::Optional), E649 .component_use(r::Optional), E355 .component_use(r::Optional), E1018.component_use(r::Optional), E649 .component_use(r::Optional), E355 .component_use(r::Optional), E1018.component_use(r::Optional), # If not used, value is interpreted as 1 E649 .component_use(r::Optional), # If not used, value is interpreted as 1 E355 .component_use(r::Optional), E1018.component_use(r::Optional), # If not used, value is interpreted as 1 E649 .component_use(r::Optional))
- C002 =
Note:
Copied from an unverified internet source
Schema::CompositeElementDef.build(:C002, "Actions Indicated", "", E704.component_use(r::Mandatory), E704.component_use(r::Optional), E704.component_use(r::Optional), E704.component_use(r::Optional), E704.component_use(r::Optional))
- C003 =
Schema::CompositeElementDef.build(:C003, "Composite Medical Procedure Identifier", "To identify a procedure by its standardized codes and applicable modifiers", E235 .component_use(r::Mandatory), E234 .component_use(r::Mandatory), # Qualified by C003-01 E1339.component_use(r::Optional), E1339.component_use(r::Optional), E1339.component_use(r::Optional), E1339.component_use(r::Optional), E352 .component_use(r::Optional), E234 .component_use(r::Optional))
- C004 =
Schema::CompositeElementDef.build(:C004, "Composite Diagnosis Code Pointer", "To identify one or more diagnosis code pointers", E1328.component_use(r::Mandatory), E1328.component_use(r::Optional), E1328.component_use(r::Optional), E1328.component_use(r::Optional))
- C005 =
Schema::CompositeElementDef.build(:C005, "Tooth Surface", "To identify one or more tooth surface codes", E1369.component_use(r::Mandatory), E1369.component_use(r::Optional), E1369.component_use(r::Optional), E1369.component_use(r::Optional), E1369.component_use(r::Optional))
- C006 =
Schema::CompositeElementDef.build(:C006, "Oral Cavity Designation", "To identify one or more areas of oral cavity", E1361.component_use(r::Mandatory), E1361.component_use(r::Optional), E1361.component_use(r::Optional), E1361.component_use(r::Optional), E1361.component_use(r::Optional))
- C022 =
Schema::CompositeElementDef.build(:C022, "Health Care Code Information", "To send health care codes and their associated dates, amounts and quantities", E1270.component_use(r::Mandatory), E1271.component_use(r::Mandatory), E1250.component_use(r::Relational), E1251.component_use(r::Relational), E782 .component_use(r::Optional), E380 .component_use(r::Optional), E799 .component_use(r::Optional), E1271.component_use(r::Relational), E1073.component_use(r::Relational), SyntaxNotes::P.build(3, 4), SyntaxNotes::E.build(8, 9))
- C023 =
Schema::CompositeElementDef.build(:C023, "Health Care Service Location Information", "To provide information that identifies the place of service or the type of bill related to the location at which a health care service was rendered", E1331 .component_use(r::Mandatory), E1332 .component_use(r::Optional), E1325 .component_use(r::Optional))
- C024 =
Schema::CompositeElementDef.build(:C024, "Related Causes Information", "To identify one or more related causes and associated state or country information", E1362.component_use(r::Mandatory), E1362.component_use(r::Optional), E1362.component_use(r::Optional), E156 .component_use(r::Optional), E26 .component_use(r::Optional))
- C030 =
Schema::CompositeElementDef.build(:C030, "Position in Segment", "Code indicating the relative position of the simple data element or composite data structure in error within a segment, count beginning with 1 for the position immediately following the segment ID; additionally, indicating the relative position of a repeating structure in error, count beginning with 1 for the position immediately following the preceding element separator; additionally indicating the relative position of a component of a composite data structure in error, count beginning with 1 for the position following the preceding element or repetition separator", E722 .component_use(r::Mandatory), E1528.component_use(r::Optional), E1686.component_use(r::Optional))
- C035 =
Note:
Copied from an unverified source
Schema::CompositeElementDef.build(:C035, "Provider Specialty Information", "", E1222.component_use(r::Mandatory), E559 .component_use(r::Optional), E1073.component_use(r::Optional))
- C040 =
Schema::CompositeElementDef.build(:C040, "Reference Identifier", "To identify one or more reference numbers or identification numbers as specified by the Reference Qualifier", E128 .component_use(r::Mandatory), E127 .component_use(r::Mandatory), E128 .component_use(r::Relational), E127 .component_use(r::Relational), E128 .component_use(r::Relational), E127 .component_use(r::Relational), SyntaxNotes::P.build(3, 4), SyntaxNotes::P.build(5, 6))
- C042 =
Schema::CompositeElementDef.build(:C042, "Adjustment Identifier", "To provide the category and identifying reference information for an adjustment", E426 .component_use(r::Mandatory), E127 .component_use(r::Optional))
- C043 =
Schema::CompositeElementDef.build(:C043, "Health Care Claim Status", "Used to convey status of the entire claim or a specific service line", E1271.component_use(r::Mandatory), E1271.component_use(r::Mandatory), E98 .component_use(r::Optional), E1270.component_use(r::Optional))
- C052 =
Note:
Copied from unverified source
Schema::CompositeElementDef.build(:C052, "Medicare Status Code", "To provide Medicare coverage and associated reason for Medicare eligibility", E1218.component_use(r::Mandatory), E1701.component_use(r::Optional), E1701.component_use(r::Optional), E1701.component_use(r::Optional))
- C056 =
Schema::CompositeElementDef.build(:C056, "Composite Race or Ethnicity Information", "", E1109.component_use(r::Optional), E1270.component_use(r::Relational), E1271.component_use(r::Relational))
- C998 =
Schema::CompositeElementDef.build(:C998, "Context Identification", "Holds information to identify a context", E9999.component_use(r::Mandatory), E9998.component_use(r::Optional))
- C999 =
Schema::CompositeElementDef.build(:C999, "Reference in Segment", "To hold the reference number of a data element and optionally component data element within a composite", E725.component_use(r::Mandatory), E725.component_use(r::Mandatory))