	HSD02	380	Quantity Description: Numeric value of quantity Industry: Number of Visits Alias: Frequency Number - 1 EMC v.6.0 Reference: Record Type 72 Field No. 6 (position 1) Required if the physician’s order or prescription for the service contains the data.	C	R	1/15	Situational
	HSD03	355	Unit or Basis for Measurement Code Description: Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken Industry: Frequency Period Alias: Frequency Period - 1 EMC v.6.0 Reference: Record Type 72 Field No. 6 (positions 2-3) Required if the physician’s order or prescription for the service contains the data.	O	ID	2/2	Situational

	HSD04	1167	Sample Selection Modulus Description: To specify the sampling frequency in terms of a modulus of the Unit of Measure, e.g., every fifth bag, every 1.5 minutes Industry: Frequency Count Required if the physician’s order or prescription for the service contains the data.	O	R	1/6	Situational
	HSD05	615	Time Period Qualifier Description: Code defining periods Industry: Duration of Visits Units Alias: Frequency Time Period Absence of data indicates PRN orders. Required if the physician’s order or prescription for the service contains the data.	C	ID	1/2	Situational

	HSD06	616	Number of Periods Description: Total number of periods Industry: Duration of Visits, Number of Units Alias: Duration - 1 EMC v.6.0 Reference: Record Type 72 Field No. 6 (positions 4-6) Required if the physician’s order or prescription for the service contains the data.	O	N0	1/3	Situational
	HSD07	678	Ship/Delivery or Calendar Pattern Code Description: Code which specifies the routine shipments, deliveries, or calendar pattern Industry: Ship, Delivery or Calendar Pattern Code Required if the physician’s order or prescription for the service contains the data.	O	ID	1/2	Situational

	Code	Name
	1	1st Week of the Month
	2	2nd Week of the Month
	3	3rd Week of the Month
	4	4th Week of the Month
	5	5th Week of the Month
	6	1st & 3rd Weeks of the Month
	7	2nd & 4th Weeks of the Month
	8	1st Working Day of Period
	9	Last Working Day of Period
	A	Monday through Friday
	B	Monday through Saturday
	C	Monday through Sunday
	D	Monday
	E	Tuesday
	F	Wednesday
	G	Thursday
	H	Friday
	J	Saturday
	K	Sunday
	L	Monday through Thursday
	N	As Directed
	O	Daily Mon. through Fri.
	S	Once Anytime Mon. through Fri.
	W	Whenever Necessary
	SA	Sunday, Monday, Thursday, Friday, Saturday
	SB	Tuesday through Saturday
	SC	Sunday, Wednesday, Thursday, Friday, Saturday
	SD	Monday, Wednesday, Thursday, Friday, Saturday
	SG	Tuesday through Friday
	SL	Monday, Tuesday and Thursday
	SP	Monday, Tuesday and Friday
	SX	Wednesday and Thursday
	SY	Monday, Wednesday and Thursday
	SZ	Tuesday, Thursday and Friday

Notes:

1. Required on claims/encounters billing/reporting home health visits where further detail is necessary to clearly substantiate medical treatment.
2. HSD01 qualifies HSD02: If the value in HSD02=1 and the value in HSD01=VS (Visits), this means “one visit”. Between HDS02 and HSD03 verbally insert a “per every.” HSD03 qualifies HSD04: If the value in HSD04=3 and the value in HSD03=DA (Day), this means “three days.” Between HSD04 and HSD05 verbally insert a “for.” HSD05 qualifies HSD06: If the value in HSD06=21 and the value in HSD05=7 (Days), this means “21 days.” The total message reads: HSD*VS*1*DA*3*7*21~ = “One visit per every three days for 21 days.”
3. Another similar data string of HSD*VS*2*DA*4*7*20~ = Two visits per every four days for 20 days.
4. An alternate way to use HSD is to employ HSD07 and/or HSD08. A data string of HSD*VS*1*****SX*D~ means “1 visit on Wednesday and Thursday morning.”

Example:

HSD*VS*1*DA**7*10~ (This indicates "1 visit every (per) 1 day (daily) for 10 days.")
HSD*VS*1*DA~ (This indicates one visit per day.)

	Ref	Id	Element Name	Req	Type	Min/Max	Usage
	HSD01	673	Quantity Qualifier Description: Code specifying the type of quantity Industry: Visits Alias: Quantity Qualifier Required if the physician’s order or prescription for the service contains the data.	C	ID	2/2	Situational

1.	P0102 - If either HSD01,HSD02 is present, then all are required
2.	C0605 - If HSD06 is present, then all of HSD05 are required

	Code	Name
	DA	Days
	MO	Months
	Q1	Quarter (Time)
	WK	Week