DSB

Disability Information

Pos: 200	Max: 1
Detail - Optional
Loop: 2200	Elements: 3

Ref

Id

Element Name

Req

Type

Min/Max

Usage

DSB01

1146

Disability Type Code
Description: Code identifying the disability status of the individual

M

ID

1/1

Required

Code

Name

1

Short Term Disability

2

Long Term Disability

3

Permanent or Total Disability

4

No Disability

DSB07

235

Product/Service ID Qualifier
Description: Code identifying the type/source of the descriptive number used in Product/Service ID (234)
Industry: Product or Service ID Qualifier
Send when required by X12 syntax.

C

ID

2/2

Situational

Code

Name

DX

International Classification of Diseases Clinical Modification (ICD-9-CM) - Diagnosis

CODE SOURCE:

131: International Classification of Diseases Clinical Mod (ICD-9-CM) Procedure

DSB08

1137

Medical Code Value
Description: Code value for describing a medical condition or procedure
Industry: Diagnosis Code
Use DSB08 to indicate if the the reason for disability is ESRD.
The only allowed value is 585 - End Stage Renal Disease.

C

AN

1/15

Situational

ExternalCodeList

Name: 131

Description: International Classification of Diseases Clinical Mod (ICD-9-CM) Procedure

1.

P0708 - If either DSB07,DSB08 is present, then all are required

1.

DSB02 is scheduled work days before the disability.

2.

DSB06 is the maximum amount of disability coverage to which the insured is entitled.

3.

DSB08 is the functional status code for the disability.

Notes:

1. This segment should only be sent when enrolling a disabled member or when disability information about an existing member is added or changed.
2. Use this segment to report a disability of either a subscriber or a dependent within the appropriate 2000 loop.

Example:

DSB*2******DX*585~