知行 EDI 规范查询平台™
Segment
X12 EDI Release 00504
SV5Durable Medical Equipment Service
To specify the claim service detail for durable medical equipment
Elements
  • SV501C003Composite Medical Procedure IdentifierM必须(Mandatory)
    23523413391339133913393522341339133913391339
    • SV50101235Product/Service ID Qualifier
      ID
      M必须(Mandatory)

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

      Codes (511)
    • SV50102234Product/Service ID
      AN
      M必须(Mandatory)
      Min 0 / Max 48

      Identifying number for a product or service

    • SV501031339Procedure 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

    • SV501041339Procedure 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

    • SV501051339Procedure 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

    • SV501061339Procedure 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

    • SV50107352Description
      AN
      O可选(Optional)
      Min 1 / Max 80

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

    • SV50108234Product/Service ID
      AN
      O可选(Optional)
      Min 1 / Max 48

      Identifying number for a product or service

    • SV501091339Procedure 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

    • SV501101339Procedure 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

    • SV501111339Procedure 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

    • SV501121339Procedure 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

  • SV502355Unit or Basis for Measurement Code
    ID
    M必须(Mandatory)

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

    Codes (884)
  • SV503380Quantity
    R
    M必须(Mandatory)
    Min 1 / Max 15

    Numeric value of quantity

  • SV504782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • SV505782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • SV506594Frequency Code
    ID
    O可选(Optional)

    Code indicating frequency or type of activities or actions being reported

    Codes (23)
  • SV507923Prognosis Code
    ID
    O可选(Optional)

    Code indicating physician's prognosis for the patient

    Codes (8)
知行 EDI 规范查询平台™ 2023 - 3.1.18
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