SV6 Anesthesia Service
Opt
AtMax 1
To specify the claim service detail for anesthesia
Elements
| Position | Element | Name | Type | Min/Max | Repeat | ||
|---|---|---|---|---|---|---|---|
AtMax 1 | |||||||
| 2 | 1332 | Facility Code Qualifier | Rel | ID | 1/2 | AtMax 1 | |
| 3 | 1331 | Facility Code Value | Rel | Alphanumeric | 1/3 | AtMax 1 | |
| 4 | 782 | Monetary Amount | Opt | Decimal | 1/18 | AtMax 1 | |
| 5 | 1328 | Diagnosis Code Pointer | Opt | Number | 1/2 | AtMax 12 | |
| 6 | 380 | Quantity | Opt | Decimal | 1/15 | AtMax 1 | |
| 7 | 1073 | Yes/No Condition or Response Code | Opt | ID | 1/1 | AtMax 1 | |
Element Details
ID1332
NameFacility Code Qualifier
LengthMin 1 / Max 2
Position2
RequirementRel
Codes
- <>AUniform Billing Claim Form Bill Type
- <>BPlace of Service Codes for Professional or Dental Services