Module: Stupidedi::Versions::FunctionalGroups::FiftyTen::ElementDefs

Defined in:

lib/stupidedi/versions/functional_groups/005010/element_defs.rb

Constant Summary

E2 =

t::Nn.new(:E2   , "Number of Accepted Transaction Sets"  , 1, 6, 0)

E19 =

t::AN.new(:E19  , "City Name"                            , 2, 30)

E26 =

t::ID.new(:E26  , "Country Code"                         , 2, 3,
s::CodeList.external("5"))

E28 =

t::Nn.new(:E28  , "Group Control Number"                 , 1, 9, 0)

E61 =

t::AN.new(:E61  , "Free-form Information"                , 1, 30)

E66 =

t::ID.new(:E66  , "Identification Code Qualifier"        , 1, 2,
            s::CodeList.build(
"1"  => s::CodeList.external("16"),
"9"  => s::CodeList.external("16"),
"21" => s::CodeList.external("121"),
"34" => "Social Security Number",
"38" => s::CodeList.external("5"),
"46" => "Electronic Transmitter Identification Number (ETIN)",
"51" => s::CodeList.external("51"),
"AC" => "Attachment Control Number",
"AD" => "Blue Cross Blue Shield Associtation Plan Code",
"BD" => "Blue Cross Provider Number",
"BS" => "Blue Shield Provider Number",
"C"  => "Insured's Changed Unique Identification Number",
"CF" => s::CodeList.external("91"),
"FI" => "Federal Taxpayer's Identification Number",
"HN" => "Health Insurance Claim (HIC) Number",
"II" => "Standard Unique Health Identifier for each Individual in the United States",
"LD" => s::CodeList.external("457"),
"LE" => s::CodeList.external("102"),
"NI" => "National Association of Insurance Commisioners (NAIC) Identification",
"MI" => "Member Identification Number",
"MC" => "Medicaid Provider",
"MR" => "Medicaid Recipient Identification Number",
"PC" => "Provider Commercial Number",
"PI" => "Payor Identification",
"PP" => "Pharmacy Processor Number",
"SJ" => s::CodeList.external("22"),
"SL" => "State License Number",
"UP" => "Unique Physician Identification Number (UPIN)",
"XV" => s::CodeList.external("540"),
"XX" => s::CodeList.external("537")))

E67 =

t::AN.new(:E67  , "Identification Code"                  , 2, 80)

E81 =

t:: R.new(:E81  , "Weight"                               , 1, 10)

E93 =

t::AN.new(:E93  , "Name"                                 , 1, 60)

E96 =

t::Nn.new(:E96  , "Number of Included Segments"          , 1, 10, 0)

E97 =

t::Nn.new(:E97  , "Number of Transaction Sets Included"  , 1, 6, 0)

E98 =

t::ID.new(:E98  , "Entity Identifier Code"               , 2, 3,
            s::CodeList.build(
"03"  => "Dependent",
"1P"  => "Provider",
"1Z"  => "Home Health Care",
"36"  => "Employer",
"40"  => "Receiver",
"41"  => "Submitter",
"45"  => "Drop-off Location",
"71"  => "Attending Physician",
"72"  => "Operating Physician",
"73"  => "Other Physician",
"74"  => "Corrected Insured",
"77"  => "Service Location",
"82"  => "Rendering Provider",
"85"  => "Billing Provider",
"87"  => "Pay-to Provider",
"98"  => "Receiver",
"AY"  => "Clearinghouse",
"DK"  => "Ordering Physician",
"DN"  => "Referring Provider",
"DQ"  => "Supervising Physician",
"FA"  => "Facility",
"GB"  => "Other Insured",
"HK"  => "Subscriber",
"IL"  => "Insured or Subscriber",
"LI"  => "Independent Lab",
"MSC" => "Mammography Screening Center",
"P3"  => "Primary Care Provider",
"PE"  => "Payee",
"PR"  => "Payer",
"PRP" => "Primary Payer",
"PW"  => "Pickup Address",
"TT"  => "Transfer To",
"QB"  => "Purchase Service Provider",
"QC"  => "Patient",
"QD"  => "Responsible Party",
"SEP" => "Secondary Payer",
"TL"  => "Testing Laboratory",
"TTP" => "Tertiary Payer",
"TU"  => "Third Party Repricing Organization (TPO)"))

E100 =

t::ID.new(:E100 , "Currency Code"                        , 3, 3,
s::CodeList.external("5"))

E116 =

t::ID.new(:E116 , "Postal Code"                          , 3, 15,
s::CodeList.external("51"))

E118 =

t:: R.new(:E118 , "Rate"                                 , 1, 9)

E123 =

t::Nn.new(:E123 , "Number of Received Transaction Sets"  , 1, 6, 0)

E124 =

t::AN.new(:E124 , "Application Receiver's Code"          , 2, 15)

E127 =

t::AN.new(:E127 , "Reference Identification"             , 1, 50)

E128 =

t::ID.new(:E128 , "Reference Identification Qualifier"   , 2, 3,
            s::CodeList.build(
"04"  => s::CodeList.external("91"),
"0B"  => "State License Number",
"0K"  => "Policy Form Identifying Number",
"1A"  => "Blue Cross Provider Number",
"1B"  => "Blue Shield Provider Number",
"1C"  => "Medicare Provider Number",
"1D"  => "Medicaid Provider Number",
"1G"  => "Provider UPIN Number",
"1H"  => "CHAMPUS Identification Number",
"1J"  => "Facility ID Number",
"1K"  => "Payor's Claim Number",
"1L"  => "Group or Policy Number",
"1S"  => "Ambulatory Patient Group (APG) Number",
"1W"  => "Member Identification Number",
"28"  => "Employee Identification Number",
"2U"  => "Payer Identification Number",
"4N"  => "Special Payment Reference Number",
"6P"  => "Group Number",
"6R"  => "Provider Control Number",
"9A"  => "Repriced Claim Reference Number",
"9B"  => "Repriced Line Item Reference Number",
"9C"  => "Adjusted Repriced Claim Reference Number",
"9D"  => "Adjusted Repriced Line Item Reference Number",
"9F"  => "Referral Number",
"ABY" => s::CodeList.external("540"),
"AP"  => "Ambulatory Payment Classification",
"APC" => s::CodeList.external("468"),
"BB"  => "Authorization Number",
"BLT" => "Billing Type",
"BT"  => "Batch Number",
"CE"  => "Class of Contract Code",
"CPT" => s::CodeList.external("133"),
"D3"  => s::CodeList.external("307"),
"D9"  => "Claim Number",
"DNS" => s::CodeList.external("16"),
"DUN" => s::CodeList.external("16"),
"E9"  => "Attachment Code",
"EA"  => "Medical Record Identification Number",
"EI"  => "Employer's Identification Number",
"EO"  => "Submitter Identification Number",
"EV"  => "Receiver Identification Number",
"EW"  => "Mammography Certification Number",
"F2"  => "Version Code - Local",
"F4"  => "Facility Certification Number",
"F5"  => "Medicare Version Code",
"F8"  => "Original Reference Number",
"FJ"  => "Line Item Control Number",
"FY"  => "Claim Office Number",
"G1"  => "Prior Authorization Number",
"G2"  => "Provider Commercial Number",
"G3"  => "Predetermination of Benefits Identification Number",
"HI"  => s::CodeList.external("121"),
"HPI" => s::CodeList.external("537"),
"ICD" => s::CodeList.external("131"),
"IG"  => "Insurance Policy Number",
"LOI" => s::CodeList.external("663"),
"LU"  => "Location Number",
"LX"  => "Qualified Products List",
"MRC" => s::CodeList.external("844"),
"NF"  => s::CodeList.external("245"),
"P4"  => "Project Code",
"PQ"  => "Payee Indentification",
"PXC" => s::CodeList.external("682"),
"RB"  => "Rate code number",
"SY"  => "Social Security Number",
"T4"  => "Signal Code",
"TJ"  => "Federal Taxpayer's Identification Number",
"VY"  => "Link Sequence Number",
"Y4"  => "Agency Claim Number",
"X4"  => "Clinical Laboratory Improvement Amendment Number",
"XZ"  => "Pharmacy Prescription Number"))

E142 =

t::AN.new(:E142 , "Application's Sender Code"            , 2, 15)

E143 =

t::ID.new(:E143 , "Transaction Set Identifier Number"    , 3, 3,
            s::CodeList.build(
"277" => "Health Care Information Status Notification",
"835" => "Health Care Claim Payment/Advice",
"837" => "Health Care Claim",
"999" => "Implementation Acknowledgement"))

E156 =

t::ID.new(:E156 , "State or Province Code"               , 2, 2,
s::CodeList.external("22"))

E166 =

t::AN.new(:E166 , "Address Information"                  , 1, 55)

E212 =

t:: R.new(:E212 , "Unit Price"                           , 1, 17)

E234 =

t::AN.new(:E234 , "Product/Service ID"                   , 1, 48)

E235 =

t::ID.new(:E235 , "Product/Service ID Qualifier"         , 2, 2,
            s::CodeList.build(
"AD" => s::CodeList.external("135"),
"A5" => s::CodeList.external("22"),
"CH" => s::CodeList.external("5"),
"CJ" => s::CodeList.external("135"),
"DC" => s::CodeList.external("897"),
"DX" => s::CodeList.external("131"),
"EN" => "EAN/UCC - 13",
"EO" => "EAN/UCC - 8",
"ER" => s::CodeList.external("576"),
"HC" => s::CodeList.external("130"),
"HP" => s::CodeList.external("716"),
"ID" => s::CodeList.external("131"),
"IP" => s::CodeList.external("896"),
"IV" => s::CodeList.external("513"),
"HI" => "HIBC (Health Care Industry Bar Code) Supplier Labeling Standard Primary Data Message",
"LB" => s::CodeList.external("663"),
"N1" => s::CodeList.external("240"),
"N2" => s::CodeList.external("240"),
"N3" => s::CodeList.external("240"),
"N4" => s::CodeList.external("240"),
"N5" => s::CodeList.external("240"),
"N6" => s::CodeList.external("240"),
"NU" => s::CodeList.external("132"),
"ON" => "Customer Order Number",
"TD" => s::CodeList.external("359"),
"UI" => "U.P.C. Consumer Package (1-5-5)",
"UK" => "GTIN 14-digit Data Structure",
"UP" => "UCC - 12",
"RB" => s::CodeList.external("132"),
"WK" => s::CodeList.external("843")))

E236 =

t::ID.new(:E236 , "Price Identifier Code"                , 3, 3)

E280 =

t:: R.new(:E280 , "Exchange Rate"                        , 4, 10)

E289 =

t::Nn.new(:E289 , "Multiple Price Quantity"              , 1, 2, 0)

E305 =

t::ID.new(:E305 , "Transaction Handling Code"            , 1, 2,
            s::CodeList.build(
"C" => "Payment Accompanies Remittance Advice",
"D" => "Make Payment Only",
"H" => "Notification Only",
"I" => "Remittance Information Only",
"P" => "Prenotification of Future Transfers",
"U" => "Split Payment and Remittance",
"X" => "Handling Party's Option to Split Payment and Remittance"))

E306 =

t::ID.new(:E306 , "Action Code"                          , 1, 2,
            s::CodeList.build(
"U"  => "Reject",
"WQ" => "Accept"))

E309 =

t::ID.new(:E309 , "Location Qualifier"                   , 1, 2,
            s::CodeList.build(
"PQ" => s::CodeList.external("51"),
"PR" => s::CodeList.external("51"),
"PS" => s::CodeList.external("51"),
"RJ" => s::CodeList.external("DOD1")))

E310 =

t::ID.new(:E310 , "Location Identifier"                  , 1, 30)

E329 =

t::AN.new(:E329 , "Transaction Set Control Number"       , 4, 9)

E332 =

t:: R.new(:E332 , "Percent, Decimal Format"              , 1, 6)

E337 =

t::TM.new(:E337 , "Time"                                 , 4, 8)

E338 =

t:: R.new(:E338 , "Terms Discount Percent"               , 1, 6)

E350 =

t::AN.new(:E350 , "Assigned Identification"              , 1, 20)

E352 =

t::AN.new(:E352 , "Description"                          , 1, 80)

E353 =

t::ID.new(:E353 , "Transaction Set Purpose Code"         , 2, 2,
            s::CodeList.build(
"00" => "Original",
"08" => "Status",
"18" => "Reissue"))

E355 =

t::ID.new(:E355 , "Unit or Basis for Measurement Code"   , 2, 2,
            s::CodeList.build(
"01" => "Actual Pounds",
"DA" => "Days",
"DH" => "Miles",
"F2" => "International Unit",
"GR" => "Gram",
"LB" => "Pound",
"ME" => "Milligram",
"MJ" => "Minutes",
"ML" => "Milliliter",
"MO" => "Months",
"UN" => "Units"))

E363 =

t::ID.new(:E363 , "Note Reference Code"                  , 3, 3,
            s::CodeList.build(
"ADD" => "Additional Information",
"CER" => "Certification Narrative",
"DCP" => "Goals, Rehabilitation Potential, or Discharge Plans",
"DGN" => "Diagnosis Description",
"TPO" => "Third Party Organization Notes"))

E364 =

t::AN.new(:E364 , "Communication Number"                 , 1, 256)

E365 =

t::ID.new(:E365 , "Communication Number Qualifier"       , 2, 2,
            s::CodeList.build(
"EM" => "Electronic Mail",
"EX" => "Telephone Extension",
"FX" => "Facsimile",
"TE" => "Telephone",
"UR" => "Uniform Resource Locator (URL)"))

E366 =

t::ID.new(:E366 , "Contract Function Code"               , 2, 2,
            s::CodeList.build(
"BL" => "Technical Department",
"CX" => "Payers Claim Office",
"IC" => "Information Contact"))

E373 =

t::DT.new(:E373 , "Date"                                 , 8, 8)

E374 =

t::ID.new(:E374 , "Date/Time Qualifier"                  , 3, 3,
            s::CodeList.build(
"009" => "Process",
"011" => "Shipped",
"036" => "Expiration",
"050" => "Received",
"090" => "Report Start",
"091" => "Report End",
"096" => "Discharge",
"150" => "Service Period Start",
"151" => "Service Period End",
"232" => "Claim Statement Period Start",
"233" => "Claim Statement Period End",
"296" => "Initial Disability Period Return To Work",
"297" => "Initial Disability Period Last Day Worked",
"304" => "Latest Visit or Consultation",
"314" => "Disability",
"360" => "Initial Disability Period Start",
"361" => "Initial Disability Period End",
"405" => "Production",
"431" => "Onset of Current Symptoms or Illness",
"435" => "Admission",
"439" => "Accident",
"444" => "First Visit or Consultation",
"453" => "Acute Manifestation of a Chronic Condition",
"454" => "Initial Treatment",
"455" => "Last X-Ray",
"461" => "Last Certification",
"463" => "Begin Therapy",
"471" => "Prescription",
"472" => "Service",
"484" => "Last Menstrual Period",
"573" => "Date Claim Paid",
"607" => "Certification Revision",
"738" => "Most Recent Hemoglobin or Hematocrit or Both",
"739" => "Most Recent Serum Creatine"))

E380 =

t:: R.new(:E380 , "Quantity"                             , 1, 15)

E426 =

t::ID.new(:E426 , "Adjustment Reason Code"               , 2, 2,
            s::CodeList.build(
"50" => "Late Charge",
"51" => "Interest Penalty Charge",
"72" => "Authorized Return",
"90" => "Early Payment Allowance",
"AH" => "Origination Fee",
"AM" => "Applied to Borrower's Account",
"AP" => "Acceleration of Benefits",
"B2" => "Rebate",
"B3" => "Recovery Allowance",
"BD" => "Bad Debt Adjustment",
"BN" => "Bonus",
"C5" => "Temporary Allowance",
"CR" => "Capitation Interest",
"CS" => "Adjustment",
"CT" => "Capitation Payment",
"CV" => "Capital Passthru",
"CW" => "Certified Registered Nurse Anesthetist Passthru",
"DM" => "Direct Medical Education Passthru",
"E3" => "Withholding",
"FB" => "Forwarding Balance",
"FC" => "Fund Allocation",
"GO" => "Graduate Medicale Education Passthru",
"HM" => "Hemophelia Clotting Factor Supplement",
"IP" => "Incentive Premium Payment",
"IR" => "Internal Revenue Service Withholding",
"IS" => "Interim Settlement",
"J1" => "Nonreimbursable",
"L3" => "Penalty",
"L6" => "Interest Owed",
"LE" => "Levy",
"LS" => "Lump Sum",
"OA" => "Organ Acquisition Passthru",
"OB" => "Offset for Affiliated Providers",
"PI" => "Periodic Interim Payment",
"PL" => "Payment Final",
"RA" => "Retro-activity Adjustment",
"RE" => "Return on Equity",
"SL" => "Student Loan Repayment",
"TL" => "Third Party Liability",
"WO" => "Overpayment Recovery",
"WU" => "Unspecified Recovery"))

E429 =

t::AN.new(:E429 , "Check Number"                         , 1, 16)

E443 =

t::AN.new(:E443 , "Contract Inquiry Reference"           , 1, 20)

E447 =

t::AN.new(:E447 , "Loop Identifier Code"                 , 1, 4)

E449 =

t::AN.new(:E449 , "Fixed Format Information"             , 1, 80)

E478 =

t::ID.new(:E478 , "Credit/Debit Flag Code"               , 1, 1,
            s::CodeList.build(
"C"   => "Credit",
"D"   => "Debit",
"ACH" => "Automated Clearing House (ACH)",
"BOP" => "Financial Institution Option",
"CHK" => "Check",
"FWT" => "Federal Reserve Funds/Wire Transfer - Nonrepetitive",
"NON" => "Non-Payment Data"))

E479 =

t::ID.new(:E479 , "Functional Identifier Code"           , 2, 2,
            s::CodeList.build(
"BE" => "Benefit Enrollment and Maintenance",
"FA" => "Functional or Implementation Acknowledgment Transaction Sets",
"HC" => "Health Care Claim",
"HI" => "Health Care Services Review Information",
"HN" => "Health Care Information Status Notification",
"HP" => "Health Care Claim Payment/Advice",
"HS" => "Eligibility, Coverage or Benefit Inquiry",
"HR" => "Health Care Claim Status Request",
"RA" => "Payment Order/Remittance Advice"))

E455 =

t::ID.new(:E455 , "Responsible Agency Code"              , 1, 2,
            s::CodeList.build(
"X" => "Accredited Standards Committee X12"))

E480 =

t::AN.new(:E480 , "Version / Release / Identifier Code"  , 1, 12,
s::CodeList.external("881"))

E481 =

t::ID.new(:E481 , "Trace Type Code"                      , 1, 2,
            s::CodeList.build(
"1" => "Current Transaction Trace Numbers",
"2" => "Referenced Transaction Trace Numbers"))

E499 =

t::AN.new(:E499 , "Condition Value"                      , 1, 10)

E506 =

t::ID.new(:E506 , "DFI Identification Number Qualifier"  , 2, 2,
            s::CodeList.build(
"01" => s::CodeList.external("4"),
"04" => s::CodeList.external("91")))

E507 =

t::AN.new(:E507 , "DFI Identification Number"            , 3, 12,
s::CodeList.external("60"))

E508 =

t::AN.new(:E508 , "Account Number"                       , 1, 35)

E509 =

t::AN.new(:E509 , "Originating Company Identifier"       , 10,10)

E510 =

t::AN.new(:E510 , "Originating Company Supplemental Code", 9, 9)

E522 =

t::ID.new(:E522 , "Amount Qualifier Code"                , 1, 3,
            s::CodeList.build(
"A8"  => "Noncovered Charges - Actual",
"AU"  => "Coverage Amount",
"B6"  => "Allowed Amount",
"D"   => "Payor Amount Paid",
"D8"  => "Discount Amount",
"DY"  => "Per Day Limit",
"EAF" => "Amount Owed",
"F4"  => "Postage Claimed",
"F5"  => "Patient Amount Paid",
"I"   => "Interest",
"KH"  => "Deduction Amount",
"NL"  => "Negative Ledger Balance",
"T"   => "Tax",
"T2"  => "Total Claim Before Taxes",
"YU"  => "In Process",
"YY"  => "Returned",
"ZK"  => "Federal Medicare or Medicaid Payment Mandate Category 1",
"ZL"  => "Federal Medicare or Medicaid Payment Mandate Category 2",
"ZM"  => "Federal Medicare or Medicaid Payment Mandate Category 3",
"ZN"  => "Federal Medicare or Medicaid Payment Mandate Category 4",
"ZO"  => "Federal Medicare or Medicaid Payment Mandate Category 5"))

E554 =

t::Nn.new(:E554 , "Assigned Number"                      , 1, 6, 0)

E559 =

t::ID.new(:E559 , "Agency Qualifier Code"                , 2, 2,
            s::CodeList.build(
"LB" => s::CodeList.external("407")))

E569 =

t::ID.new(:E569 , "Account Number Qualifier"             , 1, 3,
            s::CodeList.build(
"DA" => "Demand Deposit",
"SG" => "Savings"))

E584 =

t::ID.new(:E584 , "Employment Status Code"               , 2, 2)

E591 =

t::ID.new(:E591 , "Payment Method Code"                  , 3, 3)

E594 =

t::ID.new(:E594 , "Frequency Code"                       , 1, 1,
            s::CodeList.build(
"1" => "Weekly",
"4" => "Monthly",
"6" => "Daily"))

E609 =

t::Nn.new(:E609 , "Count"                                , 1, 9, 0)

E618 =

t::ID.new(:E618 , "Implementation Transaction Set Syntax Error Code", 1, 3,
            s::CodeList.build(
"1"  => "Transaction Set Not Supported",
"2"  => "Transaction Set Trailer Missing",
"3"  => "Transaction Set Control Number in Header and Trailer Do Not Match",
"4"  => "Number of Included Segments Does Not Match Actual Content",
"5"  => "One or More Segments in Error",
"6"  => "Missing or Invalid Transaction Set Identifier",
"7"  => "Missing or Invalid Transaction Set Control Number",
"8"  => "Authentication Key Name Unknown",
"9"  => "Encryption Key Name Unknown",
"10" => "Requested Service (Authentication or Encrypted) Not Available",
"11" => "Unknown Security Recipient",
"12" => "Incorrect Message Length (Encryption Only)",
"13" => "Message Authentication Code Failed",
"15" => "Unknown Security Originator",
"16" => "Syntax Error in Decrypted Text",
"17" => "Security Not Supported",
"18" => "Transaction Set not in Functional Group",
"19" => "Invalid Transaction Set Implementation Convention Reference",
"23" => "Transaction Set Control Number Not Unique within the Functional Group",
"24" => "S3E Security End Segment Missing for S3S Security Start Segment",
"25" => "S3S Security Start Segment Missing for S3E Security End Segment",
"26" => "S4E Security End Segment Missing for S4S Security Start Segment",
"27" => "S4S Security Start Segment Missing for S4E Security End Segment",
"I5" => "Implementation One or More Segments In Error",
"I6" => "Implementation Convention Not Supported"))

E620 =

t::ID.new(:E620 , "Implementation Segment Syntax Error Code", 1, 3,
            s::CodeList.build(
"1"  => "Unrecognized segment ID",
"2"  => "Unexpected segment",
"3"  => "Required Segment Missing",
"4"  => "Loop Occurs Over Maximum Times",
"5"  => "Segment Exceeds Maximum Use",
"6"  => "Segment Not in Defined Transaction Set",
"7"  => "Segment Not in Proper Sequence",
"8"  => "Segment Has Data Element Errors",
"I4" => "Implementation 'Not Used' Segment Present",
"I6" => "Implementation Dependent Segment Missing",
"I7" => "Implementation Loop Occurs Under Minimum Times",
"I8" => "Implementation Segment Below Minimum Use",
"I9" => "Implementation Dependent 'Not Used' Segment Present"))

E621 =

t::ID.new(:E621 , "Implementation Data Element Syntax Error Code", 1, 3,
            s::CodeList.build(
"1"   => "Required Data Element Missing",
"2"   => "Conditional Required Data Element Missing",
"3"   => "Too Many Data Elements",
"4"   => "Data Element Too Short",
"5"   => "Data Element Too Long",
"6"   => "Invalid Character In Data Element",
"7"   => "Invalid Code Value",
"8"   => "Invalid Date",
"9"   => "Invalid Time",
"10"  => "Exclusion Conditional Violated",
"12"  => "Too Many Repetitions",
"13"  => "Too Many Components",
"I6"  => "Code Value Not Used in Implementation",
"I9"  => "Implementation Dependent Data Element Missing",
"I10" => "Implementation 'Not Used' Data Element Present",
"I11" => "Implementation Too Few Repetitions",
"I12" => "Implementation Pattern Match Failure",
"I13" => "Implementation Dependent 'Not Used' Data Element Present"))

E623 =

t::ID.new(:E623 , "Time Code"                            , 2, 2,
s::CodeList.external("94"))

E628 =

t::AN.new(:E628 , "Hierachical ID Number"                , 1, 12)

E639 =

t::ID.new(:E639 , "Basis of Unit Price Code"             , 2, 2)

E640 =

t::ID.new(:E640 , "Transaction Type Code"                , 2, 2,
            s::CodeList.build(
"31" => "Subrogation Demand",
"CH" => "Chargeable",
"DG" => "Response",
"NO" => "Notice",
"RP" => "Reporting",
"RQ" => "Request",
"TH" => "Receipt Acknowledgement Advice"))

E648 =

t::ID.new(:E648 , "Price Multiplier Qualifier"           , 3, 3)

E649 =

t:: R.new(:E649 , "Multiplier"                           , 1, 10)

E659 =

t::ID.new(:E659 , "Basis of Verification Code"           , 1, 2)

E669 =

t::ID.new(:E669 , "Currency Market/Exchnage Code"        , 3, 3)

E673 =

t::ID.new(:E673 , "Quantity Qualifier"                   , 2, 2,
            s::CodeList.build(
"90" => "Acknowledged Quantity",
"AA" => "Unacknowledged Quantity",
"CA" => "Covered - Actual",
"CD" => "Co-insured - Actual",
"FL" => "Units",
"LA" => "Life-time Reserve - Actual",
"LE" => "Life-time Reserve - Estimated",
"NE" => "Non-Covered Amount - Estimated",
"NR" => "Not Replaced Blood Units",
"OU" => "Outlier Days",
"PS" => "Prescription",
"PT" => "Patients",
"QA" => "Quantity Approved",
"QC" => "Quantity Disapproved",
"VS" => "Visits",
"ZK" => "Federal Medicare or Medicaid Payment Mandate Category 1",
"ZL" => "Federal Medicare or Medicaid Payment Mandate Category 2",
"ZM" => "Federal Medicare or Medicaid Payment Mandate Category 3",
"ZN" => "Federal Medicare or Medicaid Payment Mandate Category 4",
"ZO" => "Federal Medicare or Medicaid Payment Mandate Category 5"))

E687 =

t::ID.new(:E687 , "Class of Trade Code"                  , 2, 2)

E704 =

t::ID.new(:E704 , "Paperwork/Report Action Code"         , 1, 2)

E706 =

Note:

Copied from an unverified 4010 internet source

t::ID.new(:E706 , "Entity Relation Code"                 , 2, 2)

E715 =

t::ID.new(:E715 , "Functional Group Acknowledgment Code" , 1, 1,
            s::CodeList.build(
"A" => "Accepted",
"E" => "Accepted, But Errors Were Noted",
"M" => "Rejected, Message Authentication Code (MAC) Failed",
"P" => "Partially Accepted, At Least One Transaction Set Was Rejected",
"R" => "Rejected",
"W" => "Rejected, Assurance Failed Validity Tests",
"X" => "Rejected, Content After Decryption Could Not Be Analyzed"))

E716 =

t::ID.new(:E716 , "Functional Group Syntax Error Code"   , 1, 3,
            s::CodeList.build(
"1"  => "Functional Group Not Supported",
"2"  => "Functional Group Version Not Supported",
"3"  => "Functional Group Trailer Missing",
"4"  => "Group Control Number in the Functional Group Header and Trailer Do Not Agree",
"5"  => "Number of Included Transaction Sets Does Not Match Actual Count",
"6"  => "Group Control Number Violates Syntax",
"10" => "Authentication Key Name Unknown",
"11" => "Encryption Key Name Unknown",
"12" => "Requested Service (Authentication or Encryption) Not Available",
"13" => "Unknown Security Recipient",
"14" => "Unknown Security Originator",
"15" => "Syntax Error in Decrypted Text",
"16" => "Security Not Supported",
"17" => "Incorrect Message Length (Encryption Only)",
"18" => "Message Authentication Code Failed",
"19" => "Functional Group Control Number not Unique within Interchange",
"23" => "S3E Security End Segment Missing for S3S Security Start Segment",
"24" => "S3S Security Start Segment Missing for S3E Security End Segment",
"25" => "S4E Security End Segment Missing for S4S Security Start Segment",
"26" => "S4S Security Start Segment Missing for S4E Security End Segment"))

E717 =

t::ID.new(:E717 , "Transaction Set Acknowledgment Code"  , 1, 1,
            s::CodeList.build(
"A" => "Accepted",
"E" => "Accepted But Errors Were Reported",
"M" => "Rejected, Message Authentication Code (MAC) Failed",
"R" => "Rejected",
"W" => "Rejected, Assurance Failed Validity Tests",
"X" => "Rejected, Content After Decryption Could Not Be Analyzed"))

E718 =

t::ID.new(:E718 , "Transaction Set Syntax Error Code"    , 1, 3)

E719 =

t::Nn.new(:E719 , "Segment Position in Transaction Set"  , 1, 10, 0)

E721 =

t::ID.new(:E721 , "Segment ID Code"                      , 2, 3)

E722 =

S77

t::Nn.new(:E722 , "Element Position in Segment"          , 1, 2, 0)

E724 =

t::AN.new(:E724 , "Copy of Bad Data Element"             , 1, 99)

E725 =

t::Nn.new(:E725 , "Data Element Reference Number"        , 1, 4, 0)

E734 =

S77

t::AN.new(:E734 , "Hierarchical Parent ID Number"        , 1, 12)

E735 =

t::ID.new(:E735 , "Hierarchical Level Code"              , 1, 2,
            s::CodeList.build(
"19" => "Provider of Service",
"20" => "Information Source",
"21" => "Information Receiver",
"22" => "Subscriber",
"23" => "Dependent",
"PT" => "Patient"))

E736 =

t::ID.new(:E736 , "Hierarchical Child Code"              , 1, 1,
            s::CodeList.build(
"0" => "No Subordinate HL Segment in This Hierarchical Structure",
"1" => "Additional Subordinate HL Data Segment in This Hierarchical Structure"))

E737 =

t::ID.new(:E737 , "Measurement Reference ID Code"        , 2, 2,
            s::CodeList.build(
"OG" => "Original",
"TR" => "Test Results"))

E738 =

t::ID.new(:E738 , "Measurement Qualifier"                , 2, 2,
            s::CodeList.build(
"HT" => "Height",
"R1" => "Hemoglobin",
"R2" => "Hematocrit",
"R3" => "Epoetin Starting Dosage",
"R4" => "Creatinine"))

E739 =

t:: R.new(:E739 , "Measurement Value"                    , 1, 20)

E740 =

t:: R.new(:E740 , "Range Minimum"                        , 1, 20)

E741 =

t:: R.new(:E741 , "Range Maximum"                        , 1, 20)

E752 =

t::ID.new(:E752 , "Surface/Layer/Position Code"          , 2, 2)

E753 =

t::ID.new(:E753 , "Measurement Method or Device"         , 2, 4)

E755 =

t::ID.new(:E755 , "Report Type Code"                     , 2, 2,
            s::CodeList.build(
"03" => "Report Justifying Treatment Beyond Utilization Guidelines",
"04" => "Drugs Administered",
"05" => "Treatment Diagnosis",
"06" => "Initial Assesment",
"07" => "Functional Goals",
"08" => "Plan of Treatment",
"09" => "Progress Report",
"10" => "Continued Treatment",
"11" => "Chemical Analysis",
"13" => "Certified Test Report",
"15" => "Justification for Admission",
"21" => "Recovery Plan",
"A3" => "Allergies/Sensitivies Document",
"A4" => "Autopsy Report",
"AM" => "Ambulance Certification",
"AS" => "Admission Summary",
"B2" => "Prescription",
"B3" => "Physician Order",
"B4" => "Referral Form",
"BR" => "Benchmark Testing Results",
"BS" => "Baseline",
"BT" => "Blanket Test Results",
"CB" => "Chiropractic Justification",
"CK" => "Conset Form(s)",
"CT" => "Certification",
"D2" => "Drug Profile Document",
"DA" => "Dental Models",
"DB" => "Durable Medical Equipment Prescription",
"DG" => "Diagnostic Report",
"DJ" => "Discharge Monitoring Report",
"DS" => "Discharge Summary",
"EB" => "Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer)",
"HC" => "Health Cerification",
"HR" => "Health Clinic Records",
"I5" => "Immunization Record",
"IR" => "State School Immunization Records",
"LA" => "Laboratory Results",
"M1" => "Medical Record Attachment",
"MT" => "Models",
"NN" => "Nursing Notes",
"OB" => "Operative Note",
"OC" => "Oxygen Content Averaging Report",
"OD" => "Orders and Treatments Document",
"OE" => "Objective Physical Examination (including vital signs) Document",
"OX" => "Oxygen Therapy Certification",
"OZ" => "Support Data for Claim",
"P4" => "Pathology Report",
"P5" => "Patient Medical History Document",
"PE" => "Parenteral or Enteral Certification",
"PN" => "Physical Therapy Notes",
"PO" => "Prosthetics or Orthotic Certification",
"PQ" => "Paramedical Results",
"PY" => "Physician's Report",
"PZ" => "Physical Therapy Certification",
"RB" => "Radiology Films",
"RR" => "Radiology Reports",
"RT" => "Report of Tests and Analysis Report",
"RX" => "Renewable Oxygen Content Averaging Report",
"SG" => "Symptoms Document",
"V5" => "Death Notification",
"XP" => "Photographs"))

E756 =

t::ID.new(:E756 , "Report Transmission Code"             , 1, 2,
            s::CodeList.build(
"AA" => "Available on Request at Provider Site",
"AB" => "Previously Submitted to Payer",
"AD" => "Certification Included in this Claim",
"AF" => "Narrative Segment Included in this Claim",
"AG" => "No Documentation is Required",
"BM" => "By Mail",
"EL" => "Electronically Only",
"EM" => "E-Mail",
"FT" => "File Transfer",
"FX" => "By Fax",
"NS" => "Not Specified",
"OL" => "On-Line"))

E757 =

t::Nn.new(:E757 , "Report Copies Needed"                 , 1, 2, 0)

E782 =

t:: R.new(:E782 , "Monetary Amount"                      , 1, 18)

E799 =

t::AN.new(:E799 , "Version Identifier"                   , 1, 30)

E812 =

t::ID.new(:E812 , "Payment Format Code"                  , 3, 3,
            s::CodeList.build(
"CCP" => "Cash Concentration/Disbursement plus Addenda (CCD+)(ACH)",
"CTX" => "Corporate Trade Exchange (CTX) (ACH)"))

E901 =

t::ID.new(:E901 , "Reject Reason Code"                   , 2, 2,
            s::CodeList.build(
"T1" => "Cannot Identify Provider as TPO (Third Party Organization) Participant",
"T2" => "Cannot Identify Payer as TPO (Third Party Organization) Participant",
"T3" => "Cannot Identify Insured as TPO (Third Party Organization) Participant",
"T4" => "Payer Name or Identifier Missing",
"T5" => "Certification Information Missing",
"T6" => "Claim does not contain enough information for re-pricing"))

E923 =

t::ID.new(:E923 , "Prognosis Code"                       , 1, 1)

E933 =

t::AN.new(:E933 , "Free-form Message Text"               , 1, 264)

E935 =

t::ID.new(:E935 , "Measurement Significance Code"        , 2, 2)

E936 =

t::ID.new(:E936 , "Measurement Attribute Code"           , 2, 2)

E954 =

t:: R.new(:E954 , "Percentage as Decimal"                , 1,  10)

E1005 =

t::ID.new(:E1005, "Hierarchical Structure Code"          , 4, 4,
            s::CodeList.build(
"0019" => "Information Source, Subscriber, Dependent",
"0085" => "Information Source, Information Receiver, Provider of Service, Patient"))

E1018 =

t:: R.new(:E1018, "Exponent"                             , 1, 15)

E1028 =

t::AN.new(:E1028, "Claim Submitter's Identifier"         , 1, 38)

E1029 =

t::ID.new(:E1029, "Claim Status Code"                    , 1, 2,
            s::CodeList.build(
"1"  => "Processed as Primary",
"2"  => "Processed as Secondary",
"3"  => "Processed as Tertiary",
"4"  => "Denied",
"19" => "Processed as Primary, Forwarded to Additional Payer(s)",
"20" => "Processed as Secondary, Forwarded to Additional Payer(s)",
"21" => "Processed as Tertiary, Forwarded to Additional Payer(s)",
"22" => "Reversal of Previous Payment",
"23" => "Not Our Claim, Forwarded to Additional Payer(s)",
"25" => "Predetermination Pricing Only - No Payment"))

E1032 =

t::ID.new(:E1032, "Claim Filing Indicator Code"          , 1, 2,
            s::CodeList.build(
"11" => "Other Non-Federal Programs",
"12" => "Preferred Provider Organization (PPO)",
"13" => "Point of Service (POS)",
"14" => "Exclusive Provider Organization (EPO)",
"15" => "Indemnity Insurance",
"16" => "Health Maintenance Organization (HMO) Medicare Risk",
"17" => "Dentail Maintenance Organization",
"AM" => "Automobile Medical",
"BL" => "Blue Cross/Blue Shield",
"CH" => "Champus",
"CI" => "Commercial Insurance Co.",
"DS" => "Disability",
"FI" => "Federal Employees Program",
"HM" => "Health Maintenance Organization",
"LM" => "Liability Medical",
"MA" => "Medicare Part A",
"MB" => "Medicare Part B",
"MC" => "Medicaid",
"OF" => "Other Federal Program",
"TV" => "Title V",
"VA" => "Veterans Affairs Plan",
"WC" => "Worker's Compensation Health Claim",
"ZZ" => "Mutually Defined"))

E1033 =

t::ID.new(:E1033, "Claim Adjustment Group Code"          , 1, 12,
            s::CodeList.build(
"CO" => "Contractual Obligations",
"CR" => "Corrections and Reversals",
"OA" => "Other adjustments",
"PI" => "Payor Initiated Reductions",
"PR" => "Patient Responsibility"))

E1034 =

t::ID.new(:E1034, "Claim Adjustment Reason Code"         , 1, 5,
s::CodeList.external("139"))

E1035 =

t::AN.new(:E1035, "Name Last or Organization Name"       , 1, 60)

E1036 =

t::AN.new(:E1036, "Name First"                           , 1, 35)

E1037 =

t::AN.new(:E1037, "Name Middle"                          , 1, 25)

E1038 =

t::AN.new(:E1038, "Name Prefix"                          , 1, 10)

E1039 =

t::AN.new(:E1039, "Name Suffix"                          , 1, 10)

E1048 =

t::ID.new(:E1048, "Business Function Code"               , 1, 3)

E1065 =

t::ID.new(:E1065, "Entity Type Qualifier"                , 1, 1,
            s::CodeList.build(
"1" => "Person",
"2" => "Non-Person Entity"))

E1066 =

t::ID.new(:E1066, "Citizenship Status Code"              , 1, 2)

E1067 =

t::ID.new(:E1067, "Marital Status Code"                  , 1, 1)

E1068 =

t::ID.new(:E1068, "Gender Code"                          , 1, 1,
            s::CodeList.build(
"F" => "Female",
"M" => "Male",
"U" => "Unknown"))

E1069 =

t::ID.new(:E1069, "Individual Relationship Code"         , 2, 2,
            s::CodeList.build(
"01" => "Spouse",
"18" => "Self",
"19" => "Child",
"20" => "Employee",
"21" => "Unknown",
"39" => "Organ Donor",
"40" => "Cadaver Donor",
"53" => "Life Partner",
"G8" => "Other Relationship"))

E1073 =

t::ID.new(:E1073, "Yes/No Condition or Response Code"    , 1, 1,
            s::CodeList.build(
"N" => "No",
"Y" => "Yes",
"W" => "Not Applicable"))

E1109 =

t::ID.new(:E1109, "Race or Ethnicity Code"               , 1, 1)

E1136 =

t::ID.new(:E1136, "Code Category"                        , 2, 2,
            s::CodeList.build(
"07" => "Ambulance Certification",
"09" => "Durable Medical Equipment Certification",
"12" => "Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan",
"13" => "Medicare Secondary End-Stage Renal Disease Beneficiary in Mandated Coordination Period with an Employer's Group Health Plan",
"14" => "Medicare Secondary, No-fault Insurance including Auto is Primary",
"15" => "Medicare Secondary Worker's Compensation",
"16" => "Medicare Secondary Public Health Service (PHS) or Other Federal Agency",
"41" => "Medicare Secondary Blank Lung",
"42" => "Medicare Secondary Veteran's Administration",
"43" => "Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP)",
"47" => "Medicare Secondary, Other Liability Insurance is Primary",
"70" => "Hospice",
"75" => "Functional Limitations",
"E1" => "Spectacle Lenses",
"E2" => "Contact Lenses",
"E3" => "Spectacle Frames",
"ZZ" => "Mutually Defined"))

E1138 =

t::ID.new(:E1138, "Payer Responsibility Sequence"        , 1, 1,
            s::CodeList.build(
"P" => "Primary",
"S" => "Secondary",
"T" => "Tertiary",
"U" => "Unknown",
"A" => "Payer Responsibility Four",
"B" => "Payer Responsibility Five",
"C" => "Payer Responsibility Six",
"D" => "Payer Responsibility Seven",
"E" => "Payer Responsibility Eight",
"F" => "Payer Responsibility Nine",
"G" => "Payer Responsibility Ten",
"H" => "Payer Responsibility Eleven"))

E1143 =

t::ID.new(:E1143, "Coordination of Benefits Code"        , 1, 1)

E1166 =

t::ID.new(:E1166, "Contract Type Code"                   , 2, 2,
            s::CodeList.build(
"01" => "Diagnosis Related Group (DRG)",
"02" => "Per Diem",
"03" => "Variable Per Diem",
"04" => "Flat",
"05" => "Captitated",
"06" => "Percent",
"09" => "Other"))

E1220 =

t::ID.new(:E1220, "Student Status Code"                  , 1, 1)

E1221 =

t::ID.new(:E1221, "Provider Code"                        , 1, 3,
            s::CodeList.build(
"BI" => "Billing",
"PE" => "Performing"))

E1222 =

t::AN.new(:E1222, "Provider Specialty Code"              , 1, 3)

E1223 =

Note:

Copied from an unverified 4010 internet source

t::ID.new(:E1223, "Provider Organization Code"           , 3, 3)

E1250 =

t::ID.new(:E1250, "Date Time Period Format Qualifier"    , 2, 3,
            s::CodeList.build(
"CC"  => "First Two Digits of Year Expressed in Format CCYY",
"CD"  => "Month and Year Expressed in Format MMMYYY",
"CM"  => "Date in Format CCYYMM",
"CQ"  => "Date in Format CCYYQ",
"CY"  => "Year Expressed in Format CCYY",
"D6"  => "Date Expressed in Format YYMMDD",
"D8"  => "Date Expressed in Format CCYYMMDD",
"DA"  => "Range of Dates within a Single Month Expressed in Format DD-DD",
"DB"  => "Date Expressed in Format MMDDCCYY",
"DD"  => "Day of Month in Numeric Format",
"DDT" => "Range of Dates and Time Expressed in Format CCYYMMDD-CCYYMMDDHHMM",
"DT"  => "Date and Time Expressed in Format CCYYMMDDHHMM",
"DTD" => "Range of Dates and Time Expressed in Format CCYYMMDDHHMM-CCYYMMDD",
"DTS" => "Range of Date and Time Expressed in Format CCYYMMDDHHMMSS-CCYYMMDDHHMMSS",
"EH"  => "Last Digit of Year and Julian Date Expressed in Format YDDD",
"KA"  => "Date Expressed in Format YYMMMDD",
"MD"  => "Month of Year and Day of Month Expressed in Format MMDD",
"MM"  => "Month of Year in Numeric Format",
"RD"  => "Range of Dates Expressed in Format MMDDCCYY-MMDDCCYY",
"RD2" => "Range of Years Expressed in Format YY-YY",
"RD4" => "Range of Years Expressed in Format CCYY-CCYY",
"RD5" => "Range of Years and Months Expressed in Format CCYYMM-CCYYMM",
"RD6" => "Range of Dates Expressed in Format YYMMDD-YYMMDD",
"RD8" => "Range of Dates Expressed in Format CCYYMMDD-CCYYMMDD",
"RDM" => "Range of Dates Expressed in Format YYMMDD-MMDD",
"RDT" => "Range of Date and Time Expressed in Format CCYYMMDDHHMM-CCYYMMDDHHMM",
"RMD" => "Range of Months and Days Expressed in Format MMDD-MMDD",
"RMY" => "Range of Years and Months Expressed in Format YYMM-YYMM",
"RTM" => "Range of Time Expressed in Format HHMM-HHMM",
"RTS" => "Date and Time Expressed in Format CCYYMMDDHHMMSS",
"TC"  => "Julian Date Expressed in Format DDD",
"TM"  => "Time Expressed in Format HHMM",
"TQ"  => "Date Expressed in Format MMYY",
"TR"  => "Date and Time Expressed in Format DDMMYYHHMM",
"TS"  => "Time Expressed in Format HHMMSS",
"TT"  => "Date Expressed in Format MMDDYY",
"TU"  => "Date EXpressed in Format YYDDD",
"UN"  => "Unstructured",
"YM"  => "Year and Month Expressed in Format YYMM",
"YMM" => "Range of Year and Month Expressed in Format CCYYMM-MMM",
"YY"  => "Last Two Digits of Year Expressed in Format CCYY"))

E1251 =

t::AN.new(:E1251, "Date Time Period"                     , 1, 35)

E1270 =

t::ID.new(:E1270, "Code List Qualifier Code"             , 1, 3,
            s::CodeList.build(
"65"  => s::CodeList.external("508"),
"68"  => s::CodeList.external("682"),
"AAU" => s::CodeList.external("131"),
"AAW" => s::CodeList.external("133"),
"AAX" => s::CodeList.external("131"),
"AAY" => s::CodeList.external("135"),
"ABF" => s::CodeList.external("897"),
"ABJ" => s::CodeList.external("897"),
"ABK" => s::CodeList.external("897"),
"ABN" => s::CodeList.external("897"),
"ABU" => s::CodeList.external("897"),
"ABV" => s::CodeList.external("897"),
"ADD" => s::CodeList.external("897"),
"APR" => s::CodeList.external("897"),
"AS"  => s::CodeList.external("656"),
"ASD" => s::CodeList.external("897"),
"ATD" => s::CodeList.external("897"),
"CAH" => s::CodeList.external("843"),
"BBQ" => s::CodeList.external("896"),
"BBR" => s::CodeList.external("896"),
"BE"  => s::CodeList.external("132"),
"BF"  => s::CodeList.external("131"),
"BG"  => s::CodeList.external("132"),
"BH"  => s::CodeList.external("132"),
"BI"  => s::CodeList.external("132"),
"BK"  => s::CodeList.external("131"),
"BJ"  => s::CodeList.external("131"),
"BN"  => s::CodeList.external("131"),
"BO"  => s::CodeList.external("130"),
"BP"  => s::CodeList.external("130"),
"BQ"  => s::CodeList.external("131"),
"BR"  => s::CodeList.external("131"),
"BT"  => s::CodeList.external("407"),
"BU"  => s::CodeList.external("407"),
"BS"  => s::CodeList.external("133"),
"DD"  => s::CodeList.external("131"),
"DR"  => s::CodeList.external("229"),
"EK"  => s::CodeList.external("407"),
"GR"  => s::CodeList.external("284"),
"GS"  => s::CodeList.external("407"),
"GU"  => s::CodeList.external("407"),
"GW"  => s::CodeList.external("407"),
"HE"  => s::CodeList.external("411"),
"HI"  => s::CodeList.external("121"),
"HO"  => s::CodeList.external("537"),
"JO"  => s::CodeList.external("135"),
"JP"  => s::CodeList.external("135"),
"LOI" => s::CodeList.external("663"),
"NUB" => s::CodeList.external("132"),
"NDC" => s::CodeList.external("240"),
"PR"  => s::CodeList.external("131"),
"PB"  => s::CodeList.external("407"),
"REC" => s::CodeList.external("860"),
"RET" => s::CodeList.external("859"),
"RX"  => s::CodeList.external("530"),
"S"   => s::CodeList.external("327"),
"SD"  => s::CodeList.external("131"),
"SJ"  => s::CodeList.external("407"),
"SL"  => s::CodeList.external("407"),
"TC"  => s::CodeList.external("359"),
"TD"  => s::CodeList.external("131"),
"TQ"  => s::CodeList.external("135"),
"UT"  => s::CodeList.external("528")))

E1271 =

t::AN.new(:E1271, "Industry Code"                        , 1, 30,
s::CodeList.external("508"))

E1314 =

t::ID.new(:E1314, "Admission Source Code"                , 1, 1,
s::CodeList.external("230"))

E1315 =

t::ID.new(:E1315, "Admission Type Code"                  , 1, 1,
s::CodeList.external("231"))

E1316 =

t::ID.new(:E1316, "Ambulance Transport Code"             , 1, 1)

E1317 =

t::ID.new(:E1317, "Ambulance Transport Reason Code"      , 1, 1,
            s::CodeList.build(
"A" => "Patient was transported to nearest facility for care of symptoms, complaints, or both",
"B" => "Patient was transported for the benefit of a preferred physician",
"C" => "Patient was transported for the nearness of family members",
"D" => "Patient was transported for the care of a specialist or for availability of specialized equipment",
"E" => "Patient Transferred to Rehabilitation Facility"))

E1321 =

t::ID.new(:E1321, "Condition Indicator"                  , 2, 3,
            s::CodeList.build(
"01" => "Patient was admitted to a hospital",
"04" => "Patient was moved by stretcher",
"05" => "Patient was unconscious or in shock",
"06" => "Patient was transported in an emergency situation",
"07" => "Patient had to be physically restrained",
"08" => "Patient had visible hemorrhaging",
"09" => "Ambulance service was medically necessary",
"12" => "Patient is confined to a bed or chair",
"38" => "Certification signed by the physician is on file at the supplier's office",
"65" => "Open",
"AV" => "Available - Not Used",
"IH" => "Independent at Home",
"L1" => "General Standard of 20 Degree or .5 Diopter Sphere or Cylinder Change Met",
"L2" => "Replacement Due to Loss or Theft",
"L3" => "Replacement Due to Breakage or Damage",
"L4" => "Replacement Due to Patient Preference",
"L5" => "Replacement Due to Medical Reason",
"NU" => "Not Used",
"S2" => "Under Treatment",
"ST" => "New Services Requested",
"ZV" => "Replacement Item"))

E1322 =

t::ID.new(:E1322, "Certification Type Code"              , 1, 1,
            s::CodeList.build(
"I" => "Initial",
"R" => "Renewal",
"S" => "Revised"))

E1325 =

t::ID.new(:E1325, "Claim Frequency Type Code"            , 1, 1,
s::CodeList.external("235"))

E1327 =

t::ID.new(:E1327, "Copay Status Code"                    , 1, 1,
            s::CodeList.build(
"0" => "Copay exempt"))

E1328 =

t::Nn.new(:E1328, "Diagnosis Code Pointer"               , 1, 2, 0)

E1331 =

t::AN.new(:E1331, "Facility Code Value"                  , 1, 2)

E1332 =

S237

t::ID.new(:E1332, "Facility Code Qualifier"              , 1, 2,
            s::CodeList.build(
"A" => s::CodeList.external("236"),
"B" => s::CodeList.external("237")))

E1333 =

t::ID.new(:E1333, "Record Format Code"                   , 1, 2)

E1334 =

t::ID.new(:E1334, "Professional Shortage Area Code"      , 1, 1)

E1335 =

t::ID.new(:E1335, "Insulin Type Code"                    , 1, 3)

E1336 =

t::ID.new(:E1336, "Insurance Type Code"                  , 1, 3,
            s::CodeList.build(
"02" => "Physically Handicapped Children's Program",
"03" => "Special Federal Funding",
"05" => "Disability",
"09" => "Second Opinion or Surgery",
"12" => "Medicare Secondary Working Aged Beneficiary or Spouse with Employer Group Health Plan",
"13" => "Medicare Secondary End-Stage Renal Disease Beneficiary in the Mandated Coordination Period",
"14" => "Medicare Secondary, No-fault Insurance including Auto is Primary",
"15" => "Medicare Secondary Worker's Compensation",
"16" => "Medicare Secondary Public Health Service (PHS) or Other Federal Agency",
"41" => "Medicare Secondary Blank Lung",
"42" => "Medicare Secondary Veteran's Administration",
"43" => "Medicare Secondary Disabled Beneficiary Under Age 65 with Large Group Health Plan (LGHP)",
"47" => "Medicare Secondary, Other Liability Insurance is Primary"))

E1337 =

t::ID.new(:E1337, "Level of Care Code"                   , 1, 1)

E1338 =

t::ID.new(:E1338, "Level of Service Code"                , 1, 3)

E1339 =

t::AN.new(:E1339, "Procedure Modifier"                   , 2, 2)

E1340 =

t::ID.new(:E1340, "Multiple Procedure Code"              , 1, 2)

E1341 =

t::AN.new(:E1341, "National or Local Assigned Review"    , 1, 2)

E1342 =

t::ID.new(:E1342, "Nature of Condition Code"             , 1, 1,
            s::CodeList.build(
"A" => "Acute Condition",
"C" => "Chronic Condition",
"D" => "Non-acute",
"E" => "Non-Life Threatening",
"F" => "Routine",
"G" => "Symptomatic",
"M" => "Acute Manifestation of a Chronic Condition"))

E1343 =

t::ID.new(:E1343, "Non-Institutional Claim Type Code"    , 1, 2)

E1345 =

t::ID.new(:E1345, "Nursing Home Residential Status Code" , 1, 1)

E1351 =

t::ID.new(:E1351, "Patient Signature Source Code"        , 1, 1,
            s::CodeList.build(
"P" => "Signature generated by provider because the patient was not physically present for services"))

E1352 =

t::ID.new(:E1352, "Patient Status Code"                  , 1, 2,
s::CodeList.external("239"))

E1354 =

t::ID.new(:E1354, "Diagnosis Related Group (DRG) Code"   , 1, 4,
s::CodeList.external("229"))

E1358 =

t::ID.new(:E1358, "Prosthesis, Crown, or Inlay Code"     , 1, 1)

E1359 =

t::ID.new(:E1359, "Provider Accept Assignment Code"      , 1, 1,
            s::CodeList.build(
"A" => "Assigned",
"B" => "Assigned Accepted on Clinical Lab Services Only",
"C" => "Not Assigned"))

E1360 =

t::ID.new(:E1360, "Provider Agreement Code"              , 1, 1)

E1361 =

t::ID.new(:E1361, "Oral Cavity Designation Code"         , 1, 3,
s::CodeList.external("135"))

E1362 =

t::ID.new(:E1362, "Related-Causes Code"                  , 2, 3,
            s::CodeList.build(
"AA" => "Auto Accident",
"EM" => "Employment",
"OA" => "Other Accident"))

E1363 =

t::ID.new(:E1363, "Release of Information Code"          , 1, 1,
            s::CodeList.build(
"I" => "Informed Consent to Release Medical Information for Conditions or Diagnoses Regulated by Federal Statutes",
"Y" => "Yes, Provider has a Signed Statement Permitting Release of Medical Billing Data Related to a Claim"))

E1364 =

t::ID.new(:E1364, "Review Code"                          , 1, 2)

E1365 =

t::ID.new(:E1365, "Service Type Code"                    , 1, 2)

E1366 =

t::ID.new(:E1366, "Special Program Code"                 , 2, 3)

E1367 =

t::ID.new(:E1367, "Sublaxation Level Code"               , 2, 3)

E1368 =

t::ID.new(:E1368, "Tooth Status Code"                    , 1, 2)

E1369 =

t::ID.new(:E1369, "Tooth Surface Code"                   , 1, 2)

E1371 =

t:: R.new(:E1371, "Unit Rate"                            , 1, 10)

E1383 =

t::ID.new(:E1383, "Claim Submission Reason Code"         , 2, 2)

E1384 =

t::ID.new(:E1384, "Patient Location Code"                , 1, 1)

E1473 =

t::ID.new(:E1473, "Pricing Methodology"                  , 2, 2,
            s::CodeList.build(
"00" => "Zero Pricing (Not Covered Under Contract)",
"01" => "Priced as Billed at 100%",
"02" => "Priced at the Standard Fee Schedule",
"03" => "Priced at a Contractual Percentage",
"04" => "Bundled Pricing",
"05" => "Peer Review Pricing",
"06" => "Per Diem Pricing",
"07" => "Flat Rate Pricing",
"08" => "Combination Pricing",
"09" => "Maternity Pricing",
"10" => "Other Pricing",
"11" => "Lower of Cost",
"12" => "Ratio of Cost",
"13" => "Cost Reimbursed",
"14" => "Adjustment Pricing"))

E1514 =

t::ID.new(:E1514, "Delay Reason Code"                    , 1, 2,
            s::CodeList.build(
"1"  => "Proof of Eligibility Unknown or Unavailable",
"2"  => "Litigation",
"3"  => "Authorization Delays",
"4"  => "Delay in Certifying Provider",
"5"  => "Delay in Shipping Billing Forms",
"6"  => "Delay in Delivery of Custom-made Appliances",
"7"  => "Third Party Processing Delay",
"8"  => "Delay in Eligibility Determination",
"9"  => "Original Claim Rejected or Denied Due to a Reason Unrelated to the Billing Limitation Rules",
"10" => "Administration Delay in the Prior Approval Process",
"11" => "Other",
"15" => "Natural Disaster"))

E1525 =

t::ID.new(:E1525, "Request Category Code"                , 1, 2)

E1526 =

t::ID.new(:E1526, "Policy Compliance Code"               , 1, 2,
            s::CodeList.build(
"1" => "Procedure Followed (Compliance)",
"2" => "Not Followed - Call Not Made (Non-Compliance Call Not Made)",
"3" => "Not Medically Necessary (Non-Compliance Non-Medically Necessary)",
"4" => "Not Followed Other (Non-Compliance Other)",
"5" => "Emergency Admit to Non-Network Hospital"))

E1527 =

t::ID.new(:E1527, "Exception Code"                       , 1, 2,
            s::CodeList.build(
"1" => "Non-Network Professional Provider in Network Hospital",
"2" => "Emergency Care",
"3" => "Services or Specialist not in Network",
"4" => "Out-of-Service Area",
"5" => "State Mandates",
"6" => "Other"))

E1528 =

t::Nn.new(:E1528, "Component Data Element Position in Composite", 1, 2, 0)

E1686 =

t::Nn.new(:E1686, "Repeating Data Element Position"      , 1, 4, 0)

E1705 =

t::AN.new(:E1705, "Implementation Convention Reference"  , 1, 35)

E1715 =

t::ID.new(:E1715, "Country Subdivision Code"             , 1, 3,
s::CodeList.external("5"))

E9998 =

t::AN.new(:E9998, "Context Reference"                    , 1, 35)

E9999 =

t::AN.new(:E9998, "Context Name"                         , 1, 35)

C001 =

Schema::CompositeElementDef.build(:C001,
"Composite Unit of Measure",
"To identify a composite unit of measure",
E355 .component_use(r::Mandatory),
E1018.component_use(r::Optional),
E649 .component_use(r::Optional),
E355 .component_use(r::Optional),
E1018.component_use(r::Optional),
E649 .component_use(r::Optional),
E355 .component_use(r::Optional),
E1018.component_use(r::Optional),
E649 .component_use(r::Optional),
E355 .component_use(r::Optional),
E1018.component_use(r::Optional), # If not used, value is interpreted as 1
E649 .component_use(r::Optional), # If not used, value is interpreted as 1
E355 .component_use(r::Optional),
E1018.component_use(r::Optional), # If not used, value is interpreted as 1
E649 .component_use(r::Optional))

C002 =

Note:

Copied from an unverified 4010 internet source

Schema::CompositeElementDef.build(:C002,
"Actions Indicated",
"",
E704.component_use(r::Mandatory),
E704.component_use(r::Optional),
E704.component_use(r::Optional),
E704.component_use(r::Optional),
E704.component_use(r::Optional))

C003 =

Schema::CompositeElementDef.build(:C003,
"Composite Medical Procedure Identifier",
"To identify a procedure by its standardized codes and applicable modifiers",
E235 .component_use(r::Mandatory),
E234 .component_use(r::Mandatory), # Qualified by C003-01
E1339.component_use(r::Optional),
E1339.component_use(r::Optional),
E1339.component_use(r::Optional),
E1339.component_use(r::Optional),
E352 .component_use(r::Optional),
E234 .component_use(r::Optional))

C004 =

Schema::CompositeElementDef.build(:C004,
"Composite Diagnosis Code Pointer",
"To identify one or more diagnosis code pointers",
E1328.component_use(r::Mandatory),
E1328.component_use(r::Optional),
E1328.component_use(r::Optional),
E1328.component_use(r::Optional))

C005 =

Schema::CompositeElementDef.build(:C005,
"Tooth Surface",
"To identify one or more tooth surface codes",
E1369.component_use(r::Mandatory),
E1369.component_use(r::Optional),
E1369.component_use(r::Optional),
E1369.component_use(r::Optional),
E1369.component_use(r::Optional))

C006 =

Schema::CompositeElementDef.build(:C006,
"Oral Cavity Designation",
"To identify one or more areas of oral cavity",
E1361.component_use(r::Mandatory),
E1361.component_use(r::Optional),
E1361.component_use(r::Optional),
E1361.component_use(r::Optional),
E1361.component_use(r::Optional))

C022 =

Schema::CompositeElementDef.build(:C022,
"Health Care Code Information",
"To send health care codes and their associated dates, amounts and quantities",
E1270.component_use(r::Mandatory),
E1271.component_use(r::Mandatory),
E1250.component_use(r::Relational),
E1251.component_use(r::Relational),
E782 .component_use(r::Optional),
E380 .component_use(r::Optional),
E799 .component_use(r::Optional),
E1271.component_use(r::Relational),
E1073.component_use(r::Relational),
SyntaxNotes::P.build(3, 4),
SyntaxNotes::E.build(8, 9))

C023 =

Schema::CompositeElementDef.build(:C023,
"Health Care Service Location Information",
"To provide information that identifies the place of service or the type of bill related to the location at which a health care service was rendered",
E1331 .component_use(r::Mandatory),
E1332 .component_use(r::Optional),
E1325 .component_use(r::Optional))

C024 =

Schema::CompositeElementDef.build(:C024,
"Related Causes Information",
"To identify one or more related causes and associated state or country information",
E1362.component_use(r::Optional),
E1362.component_use(r::Mandatory),
E1362.component_use(r::Optional),
E156 .component_use(r::Optional),
E26  .component_use(r::Optional))

C030 =

Schema::CompositeElementDef.build(:C030,
"Position in Segment",
"Code indicating the relative position of the simple data element or composite data structure in error within a segment, count beginning with 1 for the position immediately following the segment ID; additionally, indicating the relative position of a repeating structure in error, count beginning with 1 for the position immediately following the preceding element separator; additionally indicating the relative position of a component of a composite data structure in error, count beginning with 1 for the position following the preceding element or repetition separator",
E722 .component_use(r::Mandatory),
E1528.component_use(r::Optional),
E1686.component_use(r::Optional))

C035 =

Note:

Copied from an unverified 4010 internet source

Schema::CompositeElementDef.build(:C035,
"Provider Specialty Information",
"",
E1222.component_use(r::Mandatory),
E559 .component_use(r::Optional),
E1073.component_use(r::Optional))

C040 =

Schema::CompositeElementDef.build(:C040,
"Reference Identifier",
"To identify one or more reference numbers or identification numbers as specified by the Reference Qualifier",
E128 .component_use(r::Mandatory),
E127 .component_use(r::Mandatory),
E128 .component_use(r::Relational),
E127 .component_use(r::Relational),
E128 .component_use(r::Relational),
E127 .component_use(r::Relational),
SyntaxNotes::P.build(3, 4),
SyntaxNotes::P.build(5, 6))

C042 =

Schema::CompositeElementDef.build(:C042,
"Adjustment Identifier",
"To provide the category and identifying reference information for an adjustment",
E426 .component_use(r::Mandatory),
E127 .component_use(r::Optional))

C043 =

Schema::CompositeElementDef.build(:C043,
"Health Care Claim Status",
"Used to convey status of the entire claim or a specific service line",
E1271.component_use(r::Mandatory),
E1271.component_use(r::Mandatory),
E98  .component_use(r::Optional),
E1270.component_use(r::Optional))

C056 =

Schema::CompositeElementDef.build(:C056,
"Composite Race or Ethnicity Information",
"",
E1109.component_use(r::Optional),
E1270.component_use(r::Relational),
E1271.component_use(r::Relational))

C998 =

Schema::CompositeElementDef.build(:C998,
"Context Identification",
"Holds information to identify a context",
E9999.component_use(r::Mandatory),
E9998.component_use(r::Optional))

C999 =

Schema::CompositeElementDef.build(:C999,
"Reference in Segment",
"To hold the reference number of a data element and optionally component data element within a composite",
E725.component_use(r::Mandatory),
E725.component_use(r::Mandatory))