知行 EDI 规范查询平台™
Segment
X12 EDI Release 00405
EQEligibility or Benefit Inquiry
To specify inquired eligibility or benefit information
Elements
  • EQ011365Service Type Code
    ID
    O可选(Optional)

    Code identifying the classification of service

    Codes (183)
  • EQ02C003Composite Medical Procedure IdentifierO可选(Optional)
    2352341339133913391339352
    • EQ0201235Product/Service ID Qualifier
      ID
      M必须(Mandatory)

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

      Codes (517)
    • EQ0202234Product/Service ID
      AN
      M必须(Mandatory)
      Min 0 / Max 48

      Identifying number for a product or service

    • EQ02031339Procedure 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

    • EQ02041339Procedure 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

    • EQ02051339Procedure 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

    • EQ02061339Procedure 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

    • EQ0207352Description
      AN
      O可选(Optional)
      Min 1 / Max 80

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

  • EQ031207Coverage Level Code
    ID
    O可选(Optional)

    Code indicating the level of coverage being provided for this insured

    Codes (25)
  • EQ041336Insurance Type Code
    ID
    O可选(Optional)

    Code identifying the type of insurance policy within a specific insurance program

    Codes (47)
  • EQ05C004Composite Diagnosis Code PointerO可选(Optional)
    1328132813281328
    • EQ05011328Diagnosis Code Pointer
      N
      M必须(Mandatory)
      Min 0 / Max 2

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

    • EQ05021328Diagnosis Code Pointer
      N
      O可选(Optional)
      Min 1 / Max 2

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

    • EQ05031328Diagnosis Code Pointer
      N
      O可选(Optional)
      Min 1 / Max 2

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

    • EQ05041328Diagnosis Code Pointer
      N
      O可选(Optional)
      Min 1 / Max 2

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

知行 EDI 规范查询平台™ 2023 - 3.1.18
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