HI

Principal Procedure Information

Pos: 231	Max: 1
Detail - Optional
Loop: 2300	Elements: 1

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

BP

Health Care Financing Administration Common Procedural Coding System Principal Procedure

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

BR

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

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
Industry: Principal Procedure Code
UB-92 Ref. [UB-Name]: 80 [Principal Procedure Code and Date]
EMC v.6.0 Reference: Record Type 70 Field No. 13

M

AN

1/30

Required

ExternalCodeList

Name: 130

Description: Health Care Financing Administration Common Procedural Coding System

ExternalCodeList

Name: 131

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

1250

Date Time Period Format Qualifier
Description: Code indicating the date format, time format, or date and time format

C

ID

2/3

Situational

Code

Name

D8

Date Expressed in Format CCYYMMDD

Use code D8 when the value in composite data element HI01-1 equals “BR”.

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
UB-92 Ref. [UB-Name]: 80, “DATE” field [Principal Procedure Code and Date]
EMC v.6.0 Reference: Record Type 70 Field No. 14
Required when HI01-3 is used.

C

AN

1/35

Situational

Notes:

1. Required on Home IV therapy claims or encounters when surgery was performed during the inpatient stay from which the course of therapy was initiated.
2. Required on inpatient claims or encounters when a procedure was performed.

Example:

HI*BR:92795:D8:19980321~