知行 EDI 规范查询平台™
Segment
X12 EDI Release 00303
SV1Professional Service
To specify the claim service detail for a Health Care professional
Elements
  • SV101235Product/Service ID Qualifier
    ID
    M必须(Mandatory)

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

    Codes (275)
  • SV102234Product/Service ID
    AN
    M必须(Mandatory)
    Min 1 / Max 30

    Identifying number for a product or service.

  • SV103782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 15

    Monetary amount.

  • SV104355Unit or Basis for Measurement Code
    ID
    O可选(Optional)

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

    Codes (682)
  • SV105380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity.

  • SV1061331Facility Code
    ID
    O可选(Optional)
    Min 1 / Max 2

    Code identifying the type of facility where services were performed; the first position of the uniform bill type or place of service from health care financing administration claim form or place of treatment from the dental claim form

  • SV1071365Service Type Code
    ID
    O可选(Optional)

    Code identifying the classification of service

    Codes (21)
  • SV1081328Diagnosis Code Pointer
    N
    O可选(Optional)
    Min 1 / Max 2

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

  • SV1091339Procedure Modifier
    AN
    O可选(Optional)
    Min 2 / Max 2

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

  • SV1101328Diagnosis Code Pointer
    N
    O可选(Optional)
    Min 1 / Max 2

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

  • SV1111339Procedure Modifier
    AN
    O可选(Optional)
    Min 2 / Max 2

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

  • SV1121339Procedure Modifier
    AN
    O可选(Optional)
    Min 2 / Max 2

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

  • SV113352Description
    AN
    O可选(Optional)
    Min 1 / Max 80

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

  • SV114782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 15

    Monetary amount.

  • SV1151073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response.

    Codes (3)
  • SV1161340Multiple Procedure Code
    ID
    O可选(Optional)

    Code indicating proper adjudication and payment determination in cases involving multiple surgical procedures during the same surgical session

    Codes (3)
  • SV1171073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response.

    Codes (3)
  • SV1181073Yes/No Condition or Response Code
    ID
    O可选(Optional)

    Code indicating a Yes or No condition or response.

    Codes (3)
  • SV1191364Review Code
    ID
    O可选(Optional)

    Code identifying extenuating circumstances or justifications which might assist any review of the medical necessity for this service

    Codes (5)
  • SV1201341National or Local Assigned Review Value
    AN
    O可选(Optional)
    Min 1 / Max 2

    Value assigned by national or local organizations for various healthcare data elements

  • SV1211327Copay Status Code
    ID
    O可选(Optional)

    Code indicating whether or not co-payment requirements were met on a line by line basis

    Codes (4)
  • SV1221334Healthcare Manpower Shortage Area Code
    ID
    O可选(Optional)
    Min 1 / Max 1

    Code identifying a Healthcare Manpower Shortage Area (HMSA)

  • SV123127Reference Number
    AN
    O可选(Optional)
    Min 1 / Max 30

    Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.

  • SV124116Postal Code
    ID
    O可选(Optional)
    Min 3 / Max 9

    Code defining international postal zone code excluding punctuation and blanks (zip code for United States).

  • SV125782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 15

    Monetary amount.

  • SV1261337Level of Care Code
    ID
    O可选(Optional)

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

    Codes (7)
  • SV1271360Provider Agreement Code
    ID
    O可选(Optional)

    Code indicating the type of agreement under which the provider is submitting this claim

    Codes (7)
知行 EDI 规范查询平台™ 2023 - 3.1.18
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