HL

Billing/Pay-to Provider Hierarchical Level

Pos: 001	Max: 1
Detail - Mandatory
Loop: 2000A	Elements: 3

Ref

Id

Element Name

Req

Type

Min/Max

Usage

HL01

628

Hierarchical ID Number
Description: A unique number assigned by the sender to identify a particular data segment in a hierarchical structure
HL01 must begin with “1" and be incremented by one each time an HL is used in the transaction. Only numeric values are allowed in HL01.

M

AN

1/12

Required

HL03

735

Hierarchical Level Code
Description: Code defining the characteristic of a level in a hierarchical structure

M

ID

1/2

Required

Code

Name

20

Information Source

HL04

736

Hierarchical Child Code
Description: Code indicating if there are hierarchical child data segments subordinate to the level being described

O

ID

1/1

Required

Code

Name

1

Additional Subordinate HL Data Segment in This Hierarchical Structure.

1.

The HL segment is used to identify levels of detail information using a hierarchical structure, such as relating line-item data to shipment data, and packaging data to line-item data.

2.

The HL segment defines a top-down/left-right ordered structure.

3.

HL01 shall contain a unique alphanumeric number for each occurrence of the HL segment in the transaction set. For example, HL01 could be used to indicate the number of occurrences of the HL segment, in which case the value of HL01 would be "1" for the initial HL segment and would be incremented by one in each subsequent HL segment within the transaction.

4.

HL02 identifies the hierarchical ID number of the HL segment to which the current HL segment is subordinate.

5.

HL03 indicates the context of the series of segments following the current HL segment up to the next occurrence of an HL segment in the transaction. For example, HL03 is used to indicate that subsequent segments in the HL loop form a logical grouping of data referring to shipment, order, or item-level information.

6.

HL04 indicates whether or not there are subordinate (or child) HL segments related to the current HL segment.

Notes:

1. Use the Billing Provider HL to identify the original entity who submitted the electronic claim/encounter to the destination payer identified in Loop ID-2010BB. The Biling Provider entity may be a health care provider, a billing service or some other representative of the provider.
2. The NSF fields shown in Loop ID-2010AA and Loop ID-2010AB are intended to carry the billing provider information, not billing service information. Refer to your NSF manual for proper use of these fields. If Loop 2010AA contains information on a billing service (rather than a billing provider), do not map the information in that loop to the NSF billing provider fields for Medicare claims.
3. The Billing/Pay-to Provider HL may contain information about the Pay-to Provider entity. If the Pay-to Provider entity is the same as the Billing Provider entity, then only use Loop ID-2010AA.
4. Because this is a required segment, this is a required loop. See Appendix A for further details on ASC X12 nomenclature X12 syntax rules.
5. Receiving trading partners may have system limitations regarding the size of the transmission they can receive. The developers of this implementation guide recommend that trading partners limit the size of the transaction (ST-SE envelope) to a maximum of 5000 CLM segments. While the implementation guide sets no specific limit to the number of Billing/Pay-to Provider Hierarchical Level loops; there is an implied maximum of 5000.
6. If the Billing or Pay-to Provider is also the Rendering Provider and Loop ID-2310A is not used, the Loop ID-2000 PRV must be used to indicate which entity (Billing or Pay-to) is the Rendering Provider.

Example:

HL*1**20*1~