Principal, Admitting, E-Code and Patient Reason For Visit Diagnosis Information

Pos: 231

Max: 1

Detail - Optional

Loop: 2300

Elements: 3

Ref	Id	Element Name	Req	Type	Min/Max	Usage
HI01	C022	Health Care Code Information Description: To send health care codes and their associated dates, amounts and quantities	M	Comp		Required
	1270	Code List Qualifier Code Description: Code identifying a specific industry code list	M	ID	1/3	Required

Code

Name

Principal Diagnosis

CODE SOURCE:

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

1271

Industry Code
Description: Code indicating a code from a specific industry code list
UB-92 Ref. [UB-Name]: 67 [Principal Diagnosis Code]
EMC v.6.0 Reference: Record Type 70 Field No. 4

1/30

Required

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

	HI02	C022	Health Care Code Information Description: To send health care codes and their associated dates, amounts and quantities Required for all unscheduled outpatient visits or upon the patient’s admission to the hosptial.	O	Comp		Situational
		1270	Code List Qualifier Code Description: Code identifying a specific industry code list ZZ used to indicate the “Patient Reason For Visit.”	M	ID	1/3	Required

Code

Name

Admitting Diagnosis

CODE SOURCE:

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

Mutually Defined

ZZ used to indicate the “Patient Reason For Visit.” See Code Source 131.

1271

Industry Code
Description: Code indicating a code from a specific industry code list
UB-92 Ref. [UB-Name]: 76 [Admitting Diagnosis/Patient’s Reason for Visit]
EMC v.6.0 Reference: Record Type 70 Field No. 25

1/30

Required

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

	HI03	C022	Health Care Code Information Description: To send health care codes and their associated dates, amounts and quantities Used when necessary to report multiple additional co-existing conditions.	O	Comp		Situational
		1270	Code List Qualifier Code Description: Code identifying a specific industry code list	M	ID	1/3	Required

Code

Name

United States Department of Health and Human Services, Office of Vital Statistics E-code

CODE SOURCE:

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

1271

Industry Code
Description: Code indicating a code from a specific industry code list
UB-92 Ref. [UB-Name]: 77 [External Cause of Injury Code (E-code)]
EMC v.6.0 Reference: Record Type 70 Field No. 26

1/30

Required

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

Notes:

1. Required on all claims and encounters except claims for Religious Non-medical claims (Bill Types 4XX and 5XX) and hospital other (Bill Types 14X).
2. The Admitting Diagnosis is required on all inpatient admission claims and encounters.
3. An E-Code diagnosis is required whenever a diagnosis is needed to describe an injury, poisoning or adverse effect.
4. The Patient Reason for Visit Diagnosis is required for all unscheduled outpatient visits.

Example:

HI*BK:9976~