EDI X12 00601 EQ Segment Schema | 知行 EDI 规范查询平台

Elements

EQ01 1271 Industry Code
AN
O可选(Optional)
Min 1 / Max 30
Code indicating a code from a specific industry code list
EQ02C003Composite Medical Procedure IdentifierO可选(Optional)
23523413391339133913393522341339133913391339
- EQ0201 235 Product/Service ID Qualifier
  ID
  M必须(Mandatory)
  Code identifying the type/source of the descriptive number used in Product/Service ID (234)
  Codes (518)
- EQ0202 234 Product/Service ID
  AN
  M必须(Mandatory)
  Min 0 / Max 80
  Identifying number for a product or service
- EQ0203 1339 Procedure 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
- EQ0204 1339 Procedure 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
- EQ0205 1339 Procedure 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
- EQ0206 1339 Procedure 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
- EQ0207 352 Description
  AN
  O可选(Optional)
  Min 1 / Max 80
  A free-form description to clarify the related data elements and their content
- EQ0208 234 Product/Service ID
  AN
  O可选(Optional)
  Min 1 / Max 80
  Identifying number for a product or service
- EQ0209 1339 Procedure 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
- EQ0210 1339 Procedure 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
- EQ0211 1339 Procedure 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
- EQ0212 1339 Procedure 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
EQ03 1207 Coverage Level Code
ID
O可选(Optional)
Code indicating the level of coverage being provided for this insured
Codes (25)
- CHDChildren Only
- DEPDependents Only
- E1DEmployee and One Dependent
- E2DEmployee and Two Dependents
- E3DEmployee and Three Dependents
- E5DEmployee and One or More Dependents
- E6DEmployee and Two or More Dependents
- E7DEmployee and Three or More Dependents
- E8DEmployee and Four or More Dependents
- E9DEmployee and Five or More Dependents
- ECHEmployee and Children
- EMPEmployee Only
- ESPEmployee and Spouse
- FAMFamily
- INDIndividual
- S1CSubscriber and 1 child
- S5CSubscriber and 1 or more children
- S6CSubscriber and 2 or more children
- SPCSpouse and Children
- SPOSpouse Only
- SS1Subscriber, spouse, and 1 child
- SS5Subscriber, spouse, and 1 or more children
- SS6Subscriber, spouse, and 2 or more children
- SSPSubscriber and spouse
- TWOTwo Party
EQ04 1336 Insurance Type Code
ID
O可选(Optional)
Code identifying the type of insurance policy within a specific insurance program
Codes (51)
- 12Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan
- 13Medicare Secondary End-Stage Renal Disease Beneficiary in the Mandated Coordination Period with an Employer's Group Health Plan
- 14Medicare Secondary, No-fault Insurance including Auto is Primary
- 15Medicare Secondary Worker's Compensation
- 16Medicare Secondary Public Health Service (PHS)or Other Federal Agency
- 17Dental
- 18Vision
- 19Prescription Drugs
- 41Medicare Secondary Black Lung
- 42Medicare Secondary Veteran's Administration
- 43Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP)
- 47Medicare Secondary, Other Liability Insurance is Primary
- DDisability
- EMedicare - Point of Service (POS)
- UMultiple Options Health Plan
- APAuto Insurance Policy
- C1Commercial
- COConsolidated Omnibus Budget Reconciliation Act (COBRA)
- CPMedicare Conditionally Primary
- DBDisability Benefits
- EPExclusive Provider Organization
- FFFamily or Friends
- GPGroup Policy
- HMHealth Maintenance Organization (HMO)
- HNHealth Maintenance Organization (HMO) - Medicare Risk
- HSSpecial Low Income Medicare Beneficiary
- INIndemnity
- IPIndividual Policy
- LCLong Term Care
- LDLong Term Policy
- LILife Insurance
- LTLitigation
- MAMedicare Part A
- MBMedicare Part B
- MCMedicaid
- MDMedicare Part D
- MHMedigap Part A
- MIMedigap Part B
- MPMedicare Primary
- OTOther
- PEProperty Insurance - Personal
- PLPersonal
- PPPersonal Payment (Cash - No Insurance)
- PRPreferred Provider Organization (PPO)
- PSPoint of Service (POS)
- QMQualified Medicare Beneficiary
- RPProperty Insurance - Real
- SPSupplemental Policy
- TFTax Equity Fiscal Responsibility Act (TEFRA)
- WCWorkers Compensation
- WUWrap Up Policy
EQ05 1328 Diagnosis 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