Module: RBEDI::Codes::EQ

Extended by:
CodeSet
Defined in:
lib/rbedi/codes/eq.rb

Constant Summary collapse

SEGMENT_POSITIONS =
{
  1 => :service_type_code,
  2 => :composite_medical_procedure_identifier,
  3 => :coverage_level_code,
  4 => :insurance_type_code,
  5 => :composite_diagnosis_code_pointer
}
CODES =
{
  1 => {
					"1" => :medical_care,
					"2" => :surgical,
					"3" => :consultation,
					"4" => :diagnostic_xray,
					"5" => :diagnostic_lab,
					"6" => :radiation_therapy,
					"7" => :anesthesia,
					"8" => :surgical_assistance,
					"9" => :other_medical,
					"10" => :blood_charges,
					"11" => :used_durable_medical_equipment,
					"12" => :durable_medical_equipment_purchase,
					"13" => :ambulatory_service_center_facility,
					"14" => :renal_supplies_in_the_home,
					"15" => :alternate_method_dialysis,
					"16" => :chronic_renal_disease_crd_equipment,
					"17" => :preadmission_testing,
					"18" => :durable_medical_equipment_rental,
					"19" => :pneumonia_vaccine,
					"20" => :second_surgical_opinion,
					"21" => :third_surgical_opinion,
					"22" => :social_work,
					"23" => :diagnostic_dental,
					"24" => :periodontics,
					"25" => :restorative,
					"26" => :endodontics,
					"27" => :maxillofacial_prosthetics,
					"28" => :adjunctive_dental_services,
					"30" => :health_benefit_plan_coverage,
					"31" => :benefit_disclaimer,
					"32" => :plan_waiting_period,
					"33" => :chiropractic,
					"34" => :chiropractic_office_visits,
					"35" => :dental_care,
					"36" => :dental_crowns,
					"37" => :dental_accident,
					"38" => :orthodontics,
					"39" => :prosthodontics,
					"40" => :oral_surgery,
					"41" => :routine_preventive_dental,
					"42" => :home_health_care,
					"43" => :home_health_prescriptions,
					"44" => :home_health_visits,
					"45" => :hospice,
					"46" => :respite_care,
					"47" => :hospital,
					"48" => :hospital__inpatient,
					"49" => :hospital__room_and_board,
					"50" => :hospital__outpatient,
					"51" => :hospital__emergency_accident,
					"52" => :hospital__emergency_medical,
					"53" => :hospital__ambulatory_surgical,
					"54" => :long_term_care,
					"55" => :major_medical,
					"56" => :medically_related_transportation,
					"57" => :air_transportation,
					"58" => :cabulance,
					"59" => :licensed_ambulance,
					"60" => :general_benefits,
					"61" => :invitro_fertilization,
					"62" => :mricat_scan,
					"63" => :donor_procedures,
					"64" => :acupuncture,
					"65" => :newborn_care,
					"66" => :pathology,
					"67" => :smoking_cessation,
					"68" => :well_baby_care,
					"69" => :maternity,
					"70" => :transplants,
					"71" => :audiology_exam,
					"72" => :inhalation_therapy,
					"73" => :diagnostic_medical,
					"74" => :private_duty_nursing,
					"75" => :prosthetic_device,
					"76" => :dialysis,
					"77" => :otological_exam,
					"78" => :chemotherapy,
					"79" => :allergy_testing,
					"80" => :immunizations,
					"81" => :routine_physical,
					"82" => :family_planning,
					"83" => :infertility,
					"84" => :abortion,
					"85" => :aids,
					"86" => :emergency_services,
					"87" => :cancer,
					"88" => :pharmacy,
					"89" => :free_standing_prescription_drug,
					"90" => :mail_order_prescription_drug,
					"91" => :brand_name_prescription_drug,
					"92" => :generic_prescription_drug,
					"93" => :podiatry,
					"94" => :podiatry__office_visits,
					"95" => :podiatry__nursing_home_visits,
					"96" => :professional_physician,
					"97" => :anesthesiologist,
					"98" => :professional_physician_visit__office,
					"99" => :professional_physician_visit__inpatient,
					"a0" => :professional_physician_visit__outpatient,
					"a1" => :professional_physician_visit__nursing_home,
					"a2" => :professional_physician_visit__skilled_nursing_facility,
					"a3" => :professional_physician_visit__home,
					"a4" => :psychiatric,
					"a5" => :psychiatric__room_and_board,
					"a6" => :psychotherapy,
					"a7" => :psychiatric__inpatient,
					"a8" => :psychiatric__outpatient,
					"a9" => :rehabilitation,
					"aa" => :rehabilitation__room_and_board,
					"ab" => :rehabilitation__inpatient,
					"ac" => :rehabilitation__outpatient,
					"ad" => :occupational_therapy,
					"ae" => :physical_medicine,
					"af" => :speech_therapy,
					"ag" => :skilled_nursing_care,
					"ah" => :skilled_nursing_care__room_and_board,
					"ai" => :substance_abuse,
					"aj" => :alcoholism,
					"ak" => :drug_addiction,
					"al" => :vision_optometry,
					"am" => :frames,
					"an" => :routine_exam,
					"ao" => :lenses,
					"aq" => :nonmedically_necessary_physicalthese_physicals_are_required_by_other_entities_eg_insurance_application_pilot_license_employment_or_school,
					"ar" => :experimental_drug_therapy,
					"b" => :nonescrow_or_nonimpound_service,
					"b1" => :burn_care,
					"b2" => :brand_name_prescription_drug__formulary,
					"b3" => :brand_name_prescription_drug__nonformulary,
					"ba" => :independent_medical_evaluation,
					"bb" => :partial_hospitalization_psychiatric,
					"bc" => :day_care_psychiatric,
					"bd" => :cognitive_therapy,
					"be" => :massage_therapy,
					"bf" => :pulmonary_rehabilitation,
					"bg" => :cardiac_rehabilitation,
					"bh" => :pediatric,
					"bi" => :nursery,
					"bj" => :skin,
					"bk" => :orthopedic,
					"bl" => :cardiac,
					"bm" => :lymphatic,
					"bn" => :gastrointestinal,
					"bp" => :endocrine,
					"bq" => :neurology,
					"br" => :eye,
					"bs" => :invasive_procedures,
					"bt" => :gynecological,
					"bu" => :obstetrical,
					"bv" => :obstetricalgynecological,
					"bw" => :mail_order_prescription_drug_brand_name,
					"bx" => :mail_order_prescription_drug_generic,
					"by" => :physician_visit__office_sick,
					"bz" => :physician_visit__office_well,
					"c" => :escrow_or_impound_service,
					"c1" => :coronary_care,
					"ca" => :private_duty_nursing__inpatient,
					"cb" => :private_duty_nursing__home,
					"cc" => :surgical_benefits__professional_physician,
					"cd" => :surgical_benefits__facility,
					"ce" => :mental_health_provider__inpatient,
					"cf" => :mental_health_provider__outpatient,
					"cg" => :mental_health_facility__inpatient,
					"ch" => :mental_health_facility__outpatient,
					"ci" => :substance_abuse_facility__inpatient,
					"cj" => :substance_abuse_facility__outpatient,
					"ck" => :screening_xray,
					"cl" => :screening_laboratory,
					"cm" => :mammogram_high_risk_patient,
					"cn" => :mammogram_low_risk_patient,
					"co" => :flu_vaccination,
					"cp" => :eyewear_and_eyewear_accessories,
					"cq" => :case_management,
					"dg" => :dermatology,
					"dm" => :durable_medical_equipment,
					"ds" => :diabetic_supplies,
					"gf" => :generic_prescription_drug__formulary,
					"gn" => :generic_prescription_drug__nonformulary,
					"gy" => :allergy,
					"ic" => :intensive_care,
					"mh" => :mental_health,
					"ni" => :neonatal_intensive_care,
					"on" => :oncology,
					"pt" => :physical_therapy,
					"pu" => :pulmonary,
					"rn" => :renal,
					"rt" => :residential_psychiatric_treatment,
					"tc" => :transitional_care,
					"tn" => :transitional_nursery_care,
					"uc" => :urgent_care,
  },
				3 => {
					"chd" => :children_only,
					"dep" => :dependents_only,
					"e1d" => :employee_and_one_dependent,
					"e2d" => :employee_and_two_dependents,
					"e3d" => :employee_and_three_dependents,
					"e5d" => :employee_and_one_or_more_dependents,
					"e6d" => :employee_and_two_or_more_dependents,
					"e7d" => :employee_and_three_or_more_dependents,
					"e8d" => :employee_and_four_or_more_dependents,
					"e9d" => :employee_and_five_or_more_dependents,
					"ech" => :employee_and_children,
					"emp" => :employee_only,
					"esp" => :employee_and_spouse,
					"fam" => :family,
					"ind" => :individual,
					"s1c" => :subscriber_and_1_child,
					"s5c" => :subscriber_and_1_or_more_children,
					"s6c" => :subscriber_and_2_or_more_children,
					"spc" => :spouse_and_children,
					"spo" => :spouse_only,
					"ss1" => :subscriber_spouse_and_1_child,
					"ss5" => :subscriber_spouse_and_1_or_more_children,
					"ss6" => :subscriber_spouse_and_2_or_more_children,
					"ssp" => :subscriber_and_spouse,
					"two" => :two_party,
				},
				4 => {
					"12" => :medicare_secondary_working_aged_beneficiary_or_spouse_with_employer_group_health_plan,
					"13" => :medicare_secondary_endstage_renal_disease_beneficiary_in_the_mandated_coordination_period_with_an_employers_group_health_plan,
					"14" => :medicare_secondary_nofault_insurance_including_auto_is_primary,
					"15" => :medicare_secondary_workers_compensation,
					"16" => :medicare_secondary_public_health_service_phsor_other_federal_agency,
					"41" => :medicare_secondary_black_lung,
					"42" => :medicare_secondary_veterans_administration,
					"43" => :medicare_secondary_disabled_beneficiary_under_age_65_with_large_group_health_plan_lghp,
					"47" => :medicare_secondary_other_liability_insurance_is_primary,
					"ap" => :auto_insurance_policy,
					"c1" => :commercial,
					"co" => :consolidated_omnibus_budget_reconciliation_act_cobra,
					"cp" => :medicare_conditionally_primary,
					"d" => :disabilityprovides_periodic_payments_to_replace_income_when_an_insured_person_is_unable_to_work_as_a_result_of_illness_injury_or_disease,
					"db" => :disability_benefits,
					"e" => :medicare__point_of_service_pos,
					"ep" => :exclusive_provider_organizationgives_subscriber_a_choice_of_providers_from_an_approvedcontracted_payer_list_there_are_fixed_dollar_copayments_for_most_covered_services_in_return_for_using_plan_providers,
					"ff" => :family_or_friends,
					"gp" => :group_policytwo_or_more_people_who_are_part_of_complete_unit_who_enter_into_an_insurance_contract_with_an_insurance_company,
					"hm" => :health_maintenance_organization_hmo,
					"hn" => :health_maintenance_organization_hmo__medicare_risk,
					"hs" => :special_low_income_medicare_beneficiaryan_individual_eligible_for_medicare_for_whom_medicaid_pays_only_medicare_premiums,
					"in" => :indemnitygives_a_subscriber_the_choice_to_select_any_provider_payment_is_fixed_percentage_of_the_cost_for_covered_care_after_satisfying_an_annual_deductible,
					"ip" => :individual_policy,
					"lc" => :long_term_carecoverage_designed_to_help_pay_for_some_or_all_long_term_care_costs_reducing_the_risk_that_a_policyholder_would_need_to_deplete_all_of_his_or_her_assets_to_pay_for_long_term_care,
					"ld" => :long_term_policy,
					"li" => :life_insurance,
					"lt" => :litigation,
					"ma" => :medicare_part_a,
					"mb" => :medicare_part_b,
					"mc" => :medicaidprogram_of_health_care_services_made_available_to_medically_indigent_and_other_needy_persons_regardless_of_age_under_terms_of_a_1965_amendment_to_the_us_social_security_act,
					"mh" => :medigap_part_ahealth_insurance_policy_intended_to_cover_the_noncovered_portion_of_expenses_eligible_for_medicare_part_a_reimbursement_which_must_be_paid_by_a_medicare_beneficiary_for_health_care_services_andor_supplies_received,
					"mi" => :medigap_part_bhealth_insurance_policy_intended_to_cover_the_noncovered_portion_of_expenses_eligible_for_medicare_part_b_reimbursement_which_must_be_paid_by_a_medicare_beneficiary_for_health_care_services_andor_supplies_received,
					"mp" => :medicare_primarymedicare_has_the_primary_responsibility_to_pay_for_health_care_services_andor_supplies_received_by_a_covered_beneficiary_a_person_entitled_to_medicare_benefits,
					"ot" => :other,
					"pe" => :property_insurance__personal,
					"pl" => :personal,
					"pp" => :personal_payment_cash__no_insurance,
					"pr" => :preferred_provider_organization_ppo,
					"ps" => :point_of_service_pos,
					"qm" => :qualified_medicare_beneficiarycoverage_for_a_medicare_eligible_individual_for_whom_medicaid_pays_only_for_medicare_premiums_coinsurance_and_deductibles,
					"rp" => :property_insurance__real,
					"sp" => :supplemental_policyan_insurance_policy_intended_to_cover_noncovered_charges_of_another_insurance_policy,
					"tf" => :tax_equity_fiscal_responsibility_act_tefra,
					"u" => :multiple_options_health_plan,
					"wc" => :workers_compensationcoverage_provides_medical_treatment_rehabilitation_lost_wages_and_related_expenses_arising_from_a_job_related_injury_or_disease,
					"wu" => :wrap_up_policya_workers_compensation_policy_written_for_a_specific_job_site_which_will_include_or_cover_more_than_one_insured,
				}
}

Method Summary

Methods included from CodeSet

code, segment_position