Segment
X12 EDI Release 00504
To specify audit information about the loan
Elements
Code identifying the classification of service
Codes (191)- 1Medical Care
- 2Surgical
- 3Consultation
- 4Diagnostic X-Ray
- 5Diagnostic Lab
- 6Radiation Therapy
- 7Anesthesia
- 8Surgical Assistance
- 9Other Medical
- 10Blood Charges
- 11Used Durable Medical Equipment
- 12Durable Medical Equipment Purchase
- 13Ambulatory Service Center Facility
- 14Renal Supplies in the Home
- 15Alternate Method Dialysis
- 16Chronic Renal Disease (CRD) Equipment
- 17Pre-Admission Testing
- 18Durable Medical Equipment Rental
- 19Pneumonia Vaccine
- 20Second Surgical Opinion
- 21Third Surgical Opinion
- 22Social Work
- 23Diagnostic Dental
- 24Periodontics
- 25Restorative
- 26Endodontics
- 27Maxillofacial Prosthetics
- 28Adjunctive Dental Services
- 30Health Benefit Plan Coverage
- 31Benefit Disclaimer
- 32Plan Waiting Period
- 33Chiropractic
- 34Chiropractic Office Visits
- 35Dental Care
- 36Dental Crowns
- 37Dental Accident
- 38Orthodontics
- 39Prosthodontics
- 40Oral Surgery
- 41Routine (Preventive) Dental
- 42Home Health Care
- 43Home Health Prescriptions
- 44Home Health Visits
- 45Hospice
- 46Respite Care
- 47Hospital
- 48Hospital - Inpatient
- 49Hospital - Room and Board
- 50Hospital - Outpatient
- 51Hospital - Emergency Accident
- 52Hospital - Emergency Medical
- 53Hospital - Ambulatory Surgical
- 54Long Term Care
- 55Major Medical
- 56Medically Related Transportation
- 57Air Transportation
- 58Cabulance
- 59Licensed Ambulance
- 60General Benefits
- 61In-vitro Fertilization
- 62MRI/CAT Scan
- 63Donor Procedures
- 64Acupuncture
- 65Newborn Care
- 66Pathology
- 67Smoking Cessation
- 68Well Baby Care
- 69Maternity
- 70Transplants
- 71Audiology Exam
- 72Inhalation Therapy
- 73Diagnostic Medical
- 74Private Duty Nursing
- 75Prosthetic Device
- 76Dialysis
- 77Otological Exam
- 78Chemotherapy
- 79Allergy Testing
- 80Immunizations
- 81Routine Physical
- 82Family Planning
- 83Infertility
- 84Abortion
- 85AIDS
- 86Emergency Services
- 87Cancer
- 88Pharmacy
- 89Free Standing Prescription Drug
- 90Mail Order Prescription Drug
- 91Brand Name Prescription Drug
- 92Generic Prescription Drug
- 93Podiatry
- 94Podiatry - Office Visits
- 95Podiatry - Nursing Home Visits
- 96Professional (Physician)
- 97Anesthesiologist
- 98Professional (Physician) Visit - Office
- 99Professional (Physician) Visit - Inpatient
- BNon-escrow or Non-impound Service
- CEscrow or Impound Service
- A0Professional (Physician) Visit - Outpatient
- A1Professional (Physician) Visit - Nursing Home
- A2Professional (Physician) Visit - Skilled Nursing Facility
- A3Professional (Physician) Visit - Home
- A4Psychiatric
- A5Psychiatric - Room and Board
- A6Psychotherapy
- A7Psychiatric - Inpatient
- A8Psychiatric - Outpatient
- A9Rehabilitation
- AARehabilitation - Room and Board
- ABRehabilitation - Inpatient
- ACRehabilitation - Outpatient
- ADOccupational Therapy
- AEPhysical Medicine
- AFSpeech Therapy
- AGSkilled Nursing Care
- AHSkilled Nursing Care - Room and Board
- AISubstance Abuse
- AJAlcoholism
- AKDrug Addiction
- ALVision (Optometry)
- AMFrames
- ANRoutine Exam
- AOLenses
- APRoutine Eye Exam
- AQNonmedically Necessary Physical
- ARExperimental Drug Therapy
- B1Burn Care
- B2Brand Name Prescription Drug - Formulary
- B3Brand Name Prescription Drug - Non-Formulary
- BAIndependent Medical Evaluation
- BBPartial Hospitalization (Psychiatric)
- BCDay Care (Psychiatric)
- BDCognitive Therapy
- BEMassage Therapy
- BFPulmonary Rehabilitation
- BGCardiac Rehabilitation
- BHPediatric
- BINursery
- BJSkin
- BKOrthopedic
- BLCardiac
- BMLymphatic
- BNGastrointestinal
- BPEndocrine
- BQNeurology
- BREye
- BSInvasive Procedures
- BTGynecological
- BUObstetrical
- BVObstetrical/Gynecological
- BWMail Order Prescription Drug: Brand Name
- BXMail Order Prescription Drug: Generic
- BYPhysician Visit - Office: Sick
- BZPhysician Visit - Office: Well
- C1Coronary Care
- CAPrivate Duty Nursing - Inpatient
- CBPrivate Duty Nursing - Home
- CCSurgical Benefits - Professional (Physician)
- CDSurgical Benefits - Facility
- CEMental Health Provider - Inpatient
- CFMental Health Provider - Outpatient
- CGMental Health Facility - Inpatient
- CHMental Health Facility - Outpatient
- CISubstance Abuse Facility - Inpatient
- CJSubstance Abuse Facility - Outpatient
- CKScreening X-ray
- CLScreening laboratory
- CMMammogram, High Risk Patient
- CNMammogram, Low Risk Patient
- COFlu Vaccination
- CPEyewear and Eyewear Accessories
- CQCase Management
- DGDermatology
- DMDurable Medical Equipment
- DSDiabetic Supplies
- GFGeneric Prescription Drug - Formulary
- GNGeneric Prescription Drug - Non-Formulary
- GYAllergy
- ICIntensive Care
- MHMental Health
- NINeonatal Intensive Care
- ONOncology
- PTPhysical Therapy
- PUPulmonary
- RNRenal
- RTResidential Psychiatric Treatment
- TCTransitional Care
- TNTransitional Nursery Care
- UCUrgent Care
Code identifying the status of a business transaction, such as a claim, policy, real estate, or securities transaction
Codes (181)- 10Extended Term
- 11Automatic
- 12Follow Up
- 13Facultative
- 14Group Expired
- 15Incomplete
- 16In Force
- 17Facultative Placed
- 18Issued
- 19New Business
- 20Lapsed
- 21Mailed
- 22Policy Change
- 23Not Taken
- 24Offer Final
- 25Offer - First Subject To
- 26Paid
- 27Paid Up
- 28Payor Death
- 29Payor Disabled
- 30Pending
- 31Placed
- 32Postpone
- 33Premium Paying
- 34Quoted
- 35Reduced Paid up
- 36Reinstatement
- 37Reapproved
- 38Receipted
- 39Reissue
- 40Repended
- 41Satisfied
- 42Trial Application
- 43Limited
- 44Terminated
- 45Waived
- 46Contingent
- 47Sold
- 48Rented
- 49On Probation
- 50Under Contract
- 51Deposit
- 52Continue to Show
- 53Temporarily off the Market
- 54Leased
- 55Off-Market
- 56Forwarded
- 57Not Required
- 58Ordered
- 59Outstanding
- 60Pending 1035 Exchange
- 61Required
- 62Do Not Mail
- 63Do Not Rent or Exchange
- 64Filed
- 65Facultative Submission
- 66Additional Information
- 67Status Request
- 68Submission Change
- 69Rating Reduction Requested
- 70Facultative Opinion
- 71Reserve Facilities
- 72Offer Accepted
- 73Placed Other Carrier
- 74Capacity Unavailable
- 75Retained
- 76Death
- 77Disabled
- 78Divorced
- 79Free Look Canceled
- 80Processed
- 81Rejected
- 82Reversed
- 83Non-Transferable
- 84Sent for Registration Transfer to be Delivered at a Later Date
- 85In Transfer at Time of Request
- 86Temporary
- 87Legal Description Provided
- 88Legal Description Incomplete
- 89Legal Description Provided Via Paper
- 90Inactive Taxing Authority
- 91Inactive Taxing Authority - No longer collects separate city tax
- 92Inactive Taxing Authority - No longer collects separate school tax
- 93Inactive Taxing Authority - No longer collects separate special district tax
- 94Inactive Taxing Authority - No longer collects separate combined city and school tax
- 95Inactive Taxing Authority - No longer collects separate county tax
- 96Foreclosure
- 98Under Appeal
- 99Other Status
- 01Accepted
- 02Approved
- 03Back Bill
- 04Conditional Issue
- 05Converted
- 06Deceased
- 07Deleted
- 08Delivery Pending
- 09Double Jeopardy
- AAAnnuitized
- ABArrived
- ACActive
- ADApplicant Denied
- AEMultiple Delinquency
- AFLegal Description Not Provided
- AGPartial Payment
- AHDeeded Property
- AIMoney In-house
- AJReturned Check
- AKBankruptcy
- ALCurrent Tax Open
- AMCurrent Tax Paid
- ANTax Delinquent
- AOTax Exception or Protest
- APTax Paid
- ARAssuming Company Review
- C1Contemplated
- C2Contained in Record
- C3Current
- CCCeding Company Review - With Copy to Assuming Company
- CDCanceled
- CECeding Company Review - No Copy to Assuming Company
- CFCanceled Free Look Cash
- CHChangeable
- CICanceled by Internal Revenue Service
- CLClosed
- COComplete
- CRClosed Record
- CTContained in Transaction
- DCDeclined
- DNDeclined - No Response from Claimant to Correspondence
- DSDeclined/Paid Salvage Only
- DUDuplicate
- EFEquipment Failed
- ESEstimated
- EWExchange or Transfer Withdrawn
- EXExpired
- F0Follow Up 10 or More
- F1Follow Up 1
- F2Follow Up 2
- F3Follow Up 3
- F4Follow Up 4
- F5Follow Up 5
- F6Follow Up 6
- F7Follow Up 7
- F8Follow Up 8
- F9Follow Up 9
- FLFree Look
- FPFiled Pending Further Correspondence
- FTFuture
- FXFaxed
- IAInactive
- LALetter of Acceptance Sent
- MTMatured
- NANot in Good Order
- NPNew Premium Only
- NRNo Record Claim Receipt
- NTNo Longer Under Treatment
- OFOn File
- OHOn Hand - Under Investigation
- OPOther Parties Obligations Have Been Excluded
- PDPending Death
- PFPaid in Full
- PMPartial Payment Received
- PPPaid in Part/Denied in Part
- PRPaperwork Received
- PWPaperwork Pending
- RARated
- RCRescinded
- REReceived
- RQRequest
- RSRestricted
- RVRevoked
- SPSuspense
- SRSignature Required
- SSSuspended
- SUSurrendered
- UTUnder Treatment
- WDWithdrawn
- WIWaiting Initial Payment
- WPWaiting Period
- ZZMutually Defined