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Sub-Field: 365.29

Package: Integrated Billing

IIV RESPONSE(#365)-->365.02-->365.29

Sub-Field: 365.29


Information

Parent File Name Number Package
365.02 SUBSCRIBER ADDITIONAL INFO 365.29 Integrated Billing

Details

Field # Name Loc Type Details
.01 SEQUENCE 0;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  SEP 11, 2009
  • HELP-PROMPT:  Type a number between 1 and 99999, 0 Decimal Digits.
  • DESCRIPTION:  
    Sequential number of ZII segment.
  • TECHNICAL DESCR:  
    Sequential number 1..N, assigned automatically.
  • CROSS-REFERENCE:  365.29^B
    1)= S ^IBCN(365,DA(2),2,DA(1),9,"B",$E(X,1,30),DA)=""
    2)= K ^IBCN(365,DA(2),2,DA(1),9,"B",$E(X,1,30),DA)
.02 PLACE OF SERVICE 0;2 POINTER TO PLACE OF SERVICE FILE (#353.1) PLACE OF SERVICE(#353.1)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Select code for place of service.
  • DESCRIPTION:  
    Place of service code.
  • TECHNICAL DESCR:  
    Source: 271 HL7 message, ZII.3.1 when ZII.2.1 has value of "ZZ"
.03 DIAGNOSIS 0;3 POINTER TO ICD DIAGNOSIS FILE (#80) ICD DIAGNOSIS(#80)

  • LAST EDITED:  JUL 30, 2009
  • HELP-PROMPT:  Select diagnosis code.
  • DESCRIPTION:  
    Diagnosis code.
  • TECHNICAL DESCR:  
    Source: 271 HL7 message, ZII.3.1 when ZII.2.1 has value of "BF" or "BK"
.04 QUALIFIER 0;4 POINTER TO X12 271 CODE LIST QUALIFIER FILE (#365.044) X12 271 CODE LIST QUALIFIER(#365.044)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Select additional information qualifier.
  • DESCRIPTION:  
    Additional information qualifier.
  • TECHNICAL DESCR:  
    Source: 271 HL7 message, ZII.2.1
.05 NATURE OF INJURY CODE 0;5 POINTER TO X12 271 NATURE OF INJURY CODES FILE (#365.045) X12 271 NATURE OF INJURY CODES(#365.045)

  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Enter the Nature of Injury code.
  • DESCRIPTION:  
    Code that represents the nature of the patient injury.
  • TECHNICAL DESCR:  
    Source: 271 HL7 message, ZII.4 when ZII.2.1 has value of "GR" or "NI".
.06 NATURE OF INJURY CATEGORY 0;6 POINTER TO X12 271 INJURY CATEGORY FILE (#365.038) X12 271 INJURY CATEGORY(#365.038)

  • LAST EDITED:  MAY 06, 2013
  • HELP-PROMPT:  Select the injury category.
  • DESCRIPTION:  
    Specifies the situation or category to which the code applies. Used to categorize the data in the NATURE OF INJURY TEXT (#.07) field.
  • TECHNICAL DESCR:  
    Source: 271 HL7 message, ZII.5
.07 NATURE OF INJURY TEXT 0;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>80!($L(X)<1) X
  • LAST EDITED:  MAR 06, 2013
  • HELP-PROMPT:  Answer must be 1-80 characters in length.
  • DESCRIPTION:  
    Describes the injured body part or parts.
  • TECHNICAL DESCR:  
    Source: 271 HL7 message, ZII.6
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