REF

Document Identification Code

Pos: 180	Max: 2
Detail - Optional
Loop: 2300	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

DD

Document Identification Code

REF02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Document Control Identifier
EMC v.6.0 Reference: Record Type 71 Field No. 4
Use the form name as shown in the example. If both the 485 and 486 forms are being sent, repeat the segment.

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. Reference numbers at this position apply to the entire claim.
2. This segment is used to convey submittal of HCFA-485 and HCFA-486 data OR HCFA-486 data only.

Example:

REF*DD*485~