REF

Dependent Supplemental Identification

Pos: 180	Max: 3
Detail - Optional
Loop: 2010DA	Elements: 2

Ref

Id

Element Name

Req

Type

Min/Max

Usage

REF01

128

Reference Identification Qualifier
Description: Code qualifying the Reference Identification

M

ID

2/3

Required

Code

Name

A6

Employee Identification Number

EJ

Patient Account Number

SY

Social Security Number

The social security number may not be used for Medicare.

REF02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Dependent Supplemental Identifier

C

AN

1/30

Required

1.

R0203 - At least one of REF02,REF03 is required

1.

REF04 contains data relating to the value cited in REF02.

Notes:

1. Use this segment when necessary to provide supplemental identifiers for the dependent.
2. If the requester valued this segment with the Patient Account Number ( REF01 = “EJ”) on the request, the UMO must return the same value in this segment on the response.

Example:

REF*SY*123456789~