SV6 Anesthesia Service

Opt

AtMax 1

To specify the claim service detail for anesthesia

Elements

Position	Element	Name		Type	Min/Max	Repeat

C003Composite Medical Procedure IdentifierMandatory AtMax 1
2	1332	Facility Code Qualifier	Rel	ID	1/2	AtMax 1
3	1331	Facility Code Value	Rel	Alphanumeric	1/2	AtMax 1
4	782	Monetary Amount	Opt	Decimal	1/18	AtMax 1
C004Composite Diagnosis Code PointerOpt AtMax 1
6	380	Quantity	Opt	Decimal	1/15	AtMax 1
7	1073	Yes/No Condition or Response Code	Opt	ID	1/1	AtMax 1

ID1332

NameFacility Code Qualifier

LengthMin 1 / Max 2

Position2

RequirementRel

Codes