HI

Occurrence Information

Pos: 231	Max: 2
Detail - Optional
Loop: 2300	Elements: 12

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

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

BH

Occurrence

CODE SOURCE:

132: National Uniform Billing Committee (NUBC) Codes

1271

Industry Code
Description: Code indicating a code from a specific industry code list
Industry: Occurrence Code
UB-92 Ref. [UB-Name]: 32 (a-b) [Occurrence Codes and Dates]
33 (a-b) [Occurrence Codes and Dates]
34 (a-b) [Occurrence Codes and Dates]
35 (a-b) [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 8, 10, 12, 14, 16, 18, 20, 22, 24, 26

M

AN

1/30

Required

ExternalCodeList

Name: 132

Description: National Uniform Billing Committee (NUBC) Codes

1250

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

C

ID

2/3

Required

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: Occurrence or Occurrence Span Code Associated
Date
UB-92 Ref. [UB-Name]: 32 (a-b), “DATE” field [Occurrence Codes and Dates]
33 (a-b), “DATE” field [Occurrence Codes and Dates]
34 (a-b), “DATE” field [Occurrence Codes and Dates]
35 (a-b), “DATE” field [Occurrence Codes and Dates]
EMC v.6.0 Reference: Record Type 40 Field No. 9, 11, 13, 15, 17, 19, 21, 23, 25, 27

C

AN

1/35

Required

Notes:

1. Required when occurrence information applies to the claim or encounter.

Example:

HI*BH:42:D8:19981208~