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Segment ADI: HEALTH CARE CLAIM ADJUDICATION INFORMATION

TagADI
NameHEALTH CARE CLAIM ADJUDICATION INFORMATION
FuncTo provide adjudication information for all services in a health care claim.

Elemente

Element/GruppeNo/CodeBeschreibungOpt/Mand.
GruppeE206The identification of an object. Mandatory
GruppeE021To identify a service and any modifications. Optional
Element1229Code specifying the action to be taken or already taken.Optional
GruppeE017Amount of goods or services stated as a monetary amount in a specified currency. Optional
Element6060Alphanumeric representation of a quantity.Optional
GruppeE030To identify the adjustment category, reason and related monetary amount. Optional
Element9620Code specifying a policy limitation.Optional
Element5389Code specifying the name of a product group.Optional
GruppeE507Date and/or time, or period relevant to the specified date/time/period type. Optional
Element9639Code specifying a diagnosis category.Optional
Element5482To specify a percentage.Optional