ISA

Interchange Control Header

Pos:	Max: 1
Not Defined - Mandatory
Loop: N/A	Elements: 16

Ref

Id

Element Name

Req

Type

Min/Max

Usage

ISA01

I01

Authorization Information Qualifier
Description: Code to identify the type of information in the Authorization Information

M

ID

2/2

Required

Code

Name

00

No Authorization Information Present (No Meaningful Information in I02)

ADVISED UNLESS SECURITY REQUIREMENTS MANDATE USE OF ADDITIONAL IDENTIFICATION.

03

Additional Data Identification

ISA02

I02

Authorization Information
Description: Information used for additional identification or authorization of the interchange sender or the data in the interchange; the type of information is set by the Authorization Information Qualifier (I01)

M

AN

10/10

Required

ISA03

I03

Security Information Qualifier
Description: Code to identify the type of information in the Security Information

M

ID

2/2

Required

Code

Name

00

No Security Information Present (No Meaningful Information in I04)

ADVISED UNLESS SECURITY REQUIREMENTS MANDATE USE OF PASSWORD DATA.

01

Password

ISA04

I04

Security Information
Description: This is used for identifying the security information about the interchange sender or the data in the interchange; the type of information is set by the Security Information Qualifier (I03)

M

AN

10/10

Required

ISA05

I05

Interchange ID Qualifier
Description: Qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified
This ID qualifies the Sender in ISA06.

M

ID

2/2

Required

Code

Name

01

Duns (Dun & Bradstreet)

14

Duns Plus Suffix

20

Health Industry Number (HIN)

CODE SOURCE:

121: Health Industry Identification Number

27

Carrier Identification Number as assigned by Health Care Financing Administration (HCFA)

28

Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration (HCFA)

29

Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration (HCFA)

30

U.S. Federal Tax Identification Number

33

National Association of Insurance Commissioners Company Code (NAIC)

ZZ

Mutually Defined

ISA06

I06

Interchange Sender ID
Description: Identification code published by the sender for other parties to use as the receiver ID to route data to them; the sender always codes this value in the sender ID element

M

AN

15/15

Required

ISA07

I05

Interchange ID Qualifier
Description: Qualifier to designate the system/method of code structure used to designate the sender or receiver ID element being qualified
This ID qualifies the Receiver in ISA08.

M

ID

2/2

Required

Code

Name

01

Duns (Dun & Bradstreet)

14

Duns Plus Suffix

20

Health Industry Number (HIN)

CODE SOURCE:

121: Health Industry Identification Number

27

Carrier Identification Number as assigned by Health Care Financing Administration (HCFA)

28

Fiscal Intermediary Identification Number as assigned by Health Care Financing Administration (HCFA)

29

Medicare Provider and Supplier Identification Number as assigned by Health Care Financing Administration (HCFA)

30

U.S. Federal Tax Identification Number

33

National Association of Insurance Commissioners Company Code (NAIC)

ZZ

Mutually Defined

ISA08

I07

Interchange Receiver ID
Description: Identification code published by the receiver of the data; When sending, it is used by the sender as their sending ID, thus other parties sending to them will use this as a receiving ID to route data to them

M

AN

15/15

Required

ISA09

I08

Interchange Date
Description: Date of the interchange
The date format is YYMMDD.

M

DT

6/6

Required

ISA10

I09

Interchange Time
Description: Time of the interchange
The time format is HHMM.

M

TM

4/4

Required

ISA11

I10

Interchange Control Standards Identifier
Description: Code to identify the agency responsible for the control standard used by the message that is enclosed by the interchange header and trailer
All valid standard codes are used.

M

ID

1/1

Required

ISA12

I11

Interchange Control Version Number
Description: Code specifying the version number of the interchange control segments

M

ID

5/5

Required

Code

Name

00401

Draft Standards for Trial Use Approved for Publication by ASC X12 Procedures Review Board through October 1997

ISA13

I12

Interchange Control Number
Description: A control number assigned by the interchange sender
The Interchange Control Number, ISA13, must be identical to the associated Interchange Trailer IEA02.

M

N0

9/9

Required

ISA14

I13

Acknowledgment Requested
Description: Code sent by the sender to request an interchange acknowledgment (TA1)
See Section A.1.5.1 for interchange acknowledgment information.
All valid standard codes are used.

M

ID

1/1

Required

ISA15

I14

Usage Indicator
Description: Code to indicate whether data enclosed by this interchange envelope is test, production or information

M

ID

1/1

Required

Code

Name

P

Production Data

T

Test Data

ISA16

I15

Component Element Separator
Description: Type is not applicable; the component element separator is a delimiter and not a data element; this field provides the delimiter used to separate component data elements within a composite data structure; this value must be different than the data element separator and the segment terminator

M

1/1

Required

Notes:

The ISA is a fixed record length segment and all positions within each of the data elements must be filled. The first element separator defines the element separator to be used through the entire interchange. The segment terminator used after the ISA defines the segment terminator to be used throughout the entire interchange. Spaces in the example are represented by '.' for clarity.

Example:

ISA*00*..........*01*SECRET....*ZZ*SUBMITTERS.ID..*ZZ*RECEIVERS.ID...*930602*1253*U*00401*000000905*1*T*:~