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ITC - |
Institutional claim
UN/CEFACT Revision 2004A Segment List |
| Function: | To provide specific claim information for services performed while admitted to an institution. |
| This segment also occurs in the following versions of this standard:
D99B, D00A, D00B, D01A, D01B, D01C, D02A, D02B, D03A, D03B, D04A, D04B |
| Pos |
Segment |
M/C |
Repeat |
Repr. |
Notes |
| 010 |
|
E027 |
INVOICE TYPE |
M |
1 |
|
|
|
|
9631 |
Invoice type code |
M |
|
an..3 |
|
|
|
2013 |
Frequency code |
C |
|
an..3 |
|
| 020 |
|
6060 |
Quantity |
M |
4 |
an..35 |
|
| 030 |
|
E026 |
ADMISSION |
M |
1 |
|
|
|
|
9445 |
Admission type description code |
C |
|
an..3 |
|
|
|
9627 |
Admission source code |
C |
|
an..3 |
|
| 040 |
|
9447 |
Discharge type description code |
M |
1 |
an..3 |
|
| 050 |
|
E025 |
BASIS OF SERVICE INFORMATION |
C |
9 |
|
|
|
|
9641 |
Service basis code qualifier |
M |
|
an..3 |
|
|
|
7135 |
Product identifier |
M |
|
an..35 |
|
|
|
1131 |
Code list identification code |
C |
|
an..17 |
|
|
|
2380 |
Date or time or period text |
C |
|
an..35 |
|
|
|
2379 |
Date or time or period format code |
C |
|
an..3 |
|
|
|
5004 |
Monetary amount |
C |
|
n..35 |
|
| Pos | Position |
|---|
| M/C | Mandatory or Conditional |
|---|
| Repr. | Representation (Data or Content Type) |
|---|
| Segment ITC is used in the following messages: |
|---|
| IHCLME |
| Change indicators |
|
plus sign |
|
An addition. |
|
asterisk |
|
Addition/substraction/change to a code entry for a particular data element. |
|
hash or pound sign |
|
Changes to names. |
|
vertical bar |
|
Changes to text for descriptions, notes and functions. |
|
minus sign |
|
A deletion. |
|
letter X |
|
Marked for deletion. |
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