HI

Other Procedure Information

Pos: 231

Max: 2

Detail - Optional

Loop: 2300

Elements: 12


User Option (Usage): Situational
To supply information related to the delivery of health care

Element Summary:

 

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI02

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI04

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI05

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI06

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI07

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI08

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI09

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI10

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI11

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 16, 18, 20, 22, 24

C

AN

1/35

Situational

 

HI12

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

 

BO

Health Care Financing Administration Common Procedural Coding System

CODE SOURCE:

130: Health Care Financing Administration Common Procedural Coding System

 

BQ

International Classification of Diseases Clinical Modification (ICD-9-CM) 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: Procedure Code
UB-92 Ref. [UB-Name]: 81 (A-E) [Other Procedure Codes and Dates]
EMC v.6.0 Reference: Record Type 70 Field No. 15, 17, 19, 21, 23

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
Required if the procedure code reported is ICD-9-CM in the preceding data element. Used if needed to report a procedure date when the code reported is HCPCS. If used, the immediatley following element is required.

C

ID

2/3

Situational

 

Code

Name

 

D8

Date Expressed in Format CCYYMMDD

 

 

1251

Date Time Period
Description: Expression of a date, a time, or range of dates, times or dates and times
Industry: Procedure Date
UB-92 Ref. [UB-Name]: Record Type 70 Field No. 16, 18, 20, 22, 24
EMC v.6.0 Reference: 81 (A-E) [Other Procedure Codes and Dates]

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 additional procedures must be reported.

Example:

HI*BQ:92795:D8:19980321~


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