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ActCode
Lvl Type, Domain name and/or Mnemonic code Concept ID Mnemonic Print Name Definition/Description
1 A: ExternallyDefinedActCodes 16493
2   A: DocumentSectionType 10871

The type of document section. Possible values: review of systems, medical history, family history, microscopic findings, etc.

2   A: DocumentType 10870

The kind of document. Possible values: discharge summary, progress note, Oncology note, etc.

1 A: HL7DefinedActCodes 13954

Domain provides the root for HL7-defined detailed or rich codes for the Act classes.

2   A: ActAccountCode 14809
3     A: CreditCard 14811
4       L:  (AE) 14814 AE American Express
4       L:  (DN) 14815 DN Diner's Club
4       L:  (DV) 14816 DV Discover Card
4       L:  (MC) 14813 MC Master Card
4       L:  (V) 14812 V Visa
3     L:  (CASH) 14810 CASH Cash
2   A: ActAdjudicationCode 17616

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

3     L:  (AA) 17618 AA Adjudicated With Adjustments

The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges).

Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy

3     L:  (AR) 17619 AR Adjudicated As Refuse

The invoice element has passed through the adjudication process but payment is refused due to one or more reasons.

Includes items such as patient not covered, or invoice element is not constructed according to payor rules (e.g. 'invoice submitted too lat

3     L:  (AS) 17617 AS Adjudicated As Submitted

The invoice element was/will be paid exactly as submitted, without financial adjustment(s).

If the dollar amount stays the same, but the billing codes have been amended or financial adjustments have been applied through the adjudication process, the in

2   A: ActAdjudicationGroupCode 17968

Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals).

3     L:  (CONT) 17974 CONT by contract

Transaction counts and value totals by Contract Identifier.

3     L:  (DAY) 17969 DAY by day

Transaction counts and value totals for each calendar day within the date range specified.

3     L:  (LOC) 17976 LOC by location

Transaction counts and value totals by service location (e.g clinic).

3     L:  (MONTH) 17970 MONTH by month

Transaction counts and value totals for each calendar month within the date range specified.

3     L:  (PERIOD) 17971 PERIOD by period

Transaction counts and value totals for the date range specified.

3     L:  (PROV) 17975 PROV by provider

Transaction counts and value totals by Provider Identifier.

3     L:  (WEEK) 17972 WEEK by week

Transaction counts and value totals for each calendar week within the date range specified.

3     L:  (YEAR) 17973 YEAR by year

Transaction counts and value totals for each calendar year within the date range specified.

2   A: ActAdjudicationResultActionCode 17472

Actions to be carried out by the recipient of the Adjudication Result information.

3     L:  (DISPLAY) 17475 DISPLAY Display

The adjudication result associated is to be displayed to the receiver of the adjudication result.

3     L:  (FORM) 17473 FORM Print on Form

The adjudication result associated is to be printed on the specified form, which is then provided to the covered party.

2   A: ActAlertCode 16124

Identifies types of alerts for Act class "ALRT"

3     A: ActSuppliedItemAlertCode 16656

Identifies types of alerts regarding the administration or supply of an item to a patient.

4       A: AdministrationAlertCode 16657

Administration of the proposed therapy may be inappropriate or contraindicated as proposed

5         A: AppropriatenessAlertCode 16658
6           A: InteractionAlertCode 16659
7             S: TherapeuticProductAlert (TPROD) 17807 TPROD Therapeutic Product Alert

Proposed therapy may interact with an existing or recent therapeutic product

8               L:  (DRG) 16660 DRG Drug Interaction Alert

Proposed therapy may interact with an existing or recent drug therapy

8               L:  (NHP) 16661 NHP Natural Health Product Alert

Proposed therapy may interact with existing or recent natural health product therapy

8               L:  (NONRX) 16663 NONRX Non-Prescription Interaction Alert

Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobaco, Asprin)

7             L:  (FOOD) 16662 FOOD Food Interaction Alert

Proposed therapy may interact with certain foods

6           S: ObservationAlertCode (OBS) 16664 OBS Observation Alert

Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient

7             S: ConditionAlertCode (COND) 16665 COND Condition Alert

Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis

8               L:  (LACT) 16667 LACT Lactation Alert

Proposed therapy may be inappropriate or contraindicated when breast-feeding

8               L:  (PREG) 16666 PREG Pregnancy Alert

Proposed therapy may be inappropriate or contraindicated during pregnancy

7             S: ReactionAlertCode (REACT) 16672 REACT Reaction Alert

Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product

8               L:  (ALGY) 16674 ALGY Allergy Allert

Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.)

8               L:  (AR) 16675 AR Prior Reaction Alert

Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to the proposed product

8               L:  (INT) 16673 INT Intolerance Alert

Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.)

7             S: RelatedReactionAlertCode (RREACT) 16676 RREACT Related Reaction Alert

Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.

8               L:  (RALG) 16678 RALG Related Alergy Alert

Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.)

8               L:  (RAR) 16679 RAR Related Prior Reaction Alert

Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product.

8               L:  (RINT) 16677 RINT Related Intolerance Alert

Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.)

7             L:  (AGE) 16669 AGE Age Alert

Proposed therapy may be inappropriate or contraindicated due to patient age

7             L:  (GEN) 16671 GEN Genetic Alert

Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators.

7             L:  (GEND) 16670 GEND Gender Alert

Proposed therapy may be inappropriate or contraindicated due to patient gender.

7             L:  (LAB) 16668 LAB Lab Alert

Proposed therapy may be inappropriate or contraindicated due to recent lab test results

5         S: ComplianceAlertCode (COMPLY) 16687 COMPLY Compliance Alert

There may be an issue with the patient complying with the intentions of the proposed therapy

6           L:  (DUPTHPY) 16688 DUPTHPY Duplicate Therapy Alert

The proposed therapy appears to duplicate an existing therapy

6           L:  (PLYDOC) 16689 PLYDOC Poly-orderer Alert

A similar or identical therapy was recently ordered by a different practitioner.

6           L:  (PLYPHRM) 16690 PLYPHRM Poly-supplier Alert

This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier.

5         S: DosageProblemAlertCode (DOSE) 16680 DOSE Dosage problem

Proposed dosage instructions for therapy differ from standard practice.

6           S: DoseDurationAlertCode (DOSEDUR) 16684 DOSEDUR Dose-Duration Alert

Proposed length of therpay differs from standard practice

7             L:  (DOSEDURH) 16686 DOSEDURH Dose-Duration High Alert

Proposed length of therapy is longer than standard practice

7             L:  (DOSEDURL) 16685 DOSEDURL Dose-Duration Low Alert

Proposed length of therapy is shorter than that necessary for therapeutic effect

6           L:  (DOSEH) 16681 DOSEH High Dose Alert

Proposed dosage exceeds standard practice

6           L:  (DOSEIVL) 16683 DOSEIVL Dose-Interval Alert

Proposed dosage interval/timing differs from standard practice

6           L:  (DOSEL) 16682 DOSEL Low Dose Alert

Proposed dosage is below suggested therapeutic levels

5         A: DrugActionAlert 17815

Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy

5         A: TimingAlert 17816

Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.

6           L:  (ENDLATE) 17818 ENDLATE End Too Late Alert

Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy

6           L:  (STRTLATE) 17817 STRTLATE Start Too Late Alert

Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition

4       A: SupplyAlertCode 16691

Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy

5         L:  (TOOLATE) 16693 TOOLATE Refill Too Late Alert

The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions

5         L:  (TOOSOON) 16692 TOOSOON Refill Too Soon Alert

The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions

3     A: ClinicalActionAlert 17814

Identifies types of alerts regarding to the performance of a clinical action on a patient.

2   A: ActAlertManagementCode 16695

Codes dealing with the management of Alert observations

3     S: OtherActionTakenManagementCode (8) 16703 8 Other Action Taken

Order is performed as issued, but other action taken to mitigate potential adverse effects

4       L:  (10) 16705 10 Provided Patient Education

Provided education or training to the patient on appropriate therapy use

4       L:  (11) 16706 11 Added Concurrent Therapy

Instituted an additional therapy to mitigate potential negative effects

4       L:  (12) 16707 12 Temporarily Suspended Concurrent Therapy

Suspended existing therapy that triggered interaction for the duration of this therapy

4       L:  (13) 16708 13 Stopped Concurrent Thermapy

Aborted existing therapy that triggered interaction.

4       L:  (9) 16704 9 Instituted Ongoing Monitoring Program

Arranged to monitor patient for adverse effects

3     S: SupplyAppropriateManagementCode (14) 16709 14 Supply Appropriate

Confirmed supply action appropriate

4       L:  (15) 16710 15 Replacement

Patient's existing supply was lost/wasted

4       L:  (16) 16711 16 Vacation Supply

Supply date is due to patient vacation

4       L:  (17) 16712 17 Emergency Supply

Supply date is intended to carry patient over weekend

4       L:  (18) 17835 18 Leave of Absense

Supply is intended for use during a leave of absense from an institution

3     S: TherapyAppropriateManagementCode (1) 16696 1 Therapy Appropriate

Confirmed drug therapy appropriate

4       S: ConsultedPrescriberManagementCode (5) 16700 5 Consulted Prescriber

Consulted prescriber, therapy confirmed

5         L:  (6) 16701 6 Prescriber Declined Change

Consulted prescriber and recommended change, prescriber declined

4       L:  (19) 17836 19 Consulted Supplier

Consulted other supplier/pharmacy, therapy confirmed

4       L:  (2) 16697 2 Assessed Patient

Assessed patient, therapy is appropriate

4       L:  (3) 16698 3 Patient Explanation

Patient gave adequate explanation

4       L:  (4) 16699 4 Consulted Other Source

Consulted other supply source, therapy still appropriate

4       L:  (7) 16702 7 Interacting Therapy No Longer Active/Planned

Concurrent therapy triggering alert is no longer on-going or planned

2   A: ActBillingArrangementCode 17478

The type of provision made for reimbursing for the healthcare services provided over a specific period.

3     L:  (BLK) 17480 BLK Block Funding

A billing arrangement where the practice is paid a lump sum to provide a particular volume of services (not a restricted set of services as in contract).

3     L:  (CAP) 17484 CAP Capitation Funding

A billing arrangement where the payment made to a practice is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the practice.

3     L:  (CONT) 17481 CONT Contract Funding

A billing arrangement where the practice is paid a lump sum to provide a particular volume of one or more services or groups of services.

3     L:  (FFS) 17479 FFS Fee For Service

A billing arrangement where a fee is charged for each treatment, procedure or product (good).

3     L:  (ROST) 17482 ROST Roster Funding

A billing arrangement where funding is based on a list of individuals registered as patients of the provider.

3     L:  (SESS) 17483 SESS Sessional Funding

A billing arrangement where the payment made to a practice is based on the number of hours the provider in that practice spent providing services to those they treated.

2   A: ActBoundedROICode 17896

Type of bounded ROI.

3     L:  (ROIFS) 17897 ROIFS fully specified ROI

A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those dimensions participate that are specified by boundary criteria, whereas all other dimensions are excluded. For example a ROI to mark an episode of "ST elevation" in a subset of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3, and V4.

3     L:  (ROIPS) 17898 ROIPS partially specified ROI

A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least all values in the dimensions specified by the boundary criteria participate. For example, if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make sense to exclude any EKG leads from the observation and the partially specified ROI would contain only one boundary for time indicating the time interval where VFib was observed.

2   A: ActContainerRegistrationCode 14058

Constrains the ActCode to the domain of Container Registration

3     L:  (I) 14059 I Identified

used by one system to inform another that it has received a container

3     L:  (L) 14063 L Left Equipment

used by one system to inform another that the container has been released from that system.

3     L:  (M) 14064 M Missing

used by one system to inform another that the container did not arrive at its next expected location.

3     L:  (O) 14061 O In Process

used by one system to inform another that the specific container is being processed by the equipment. It is useful as a response to a query about Container Status, when the specific step of the process is not relevant.

3     L:  (P) 14060 P In Position

used by one system to inform another that the container is in position for specimen transfer (e.g., container removal from track, pipetting, etc.).

3     L:  (R) 14062 R Process Completed

status is used by one system to inform another that the processing has been completed, but the container has not been released from that system.

3     L:  (X) 14065 X Container Unavailable

used by one system to inform another that the container is no longer available within the scope of the system (e.g., tube broken or discarded).

2   A: ActControlVariable 16857

An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g., time skew) or the position of the body while measuring blood pressure.

Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g., it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure.)

3     L:  (AUTO) 16860 AUTO auto-repeat permission

Specifies whether or not automatic repeat testing is to be initiated on specimens.

3     L:  (ENDC) 16858 ENDC endogenous content

A baseline value for the measured test that is inherently contained in the diluent. In the calculation of the actual result for the measured test, this baseline value is normally considered..

3     L:  (REFLEX) 16859 REFLEX reflex permission

Specifies whether or not further testing may be automatically or manually initiated on specimens.

2   A: ActCoverageConfirmationCode 17487

Response to an insurance coverage eligibility query or authorization request.

3     A: ActCoverageAuthorizationConfirmationCode 17491

Indication of authorization for healthcare service(s) and/or product(s). If authorization is approved, funds are set aside.

4       L:  (AUTH) 17492 AUTH Authorized

Authorization approved and funds have been set aside to pay for specified healthcare service(s) and/or product(s) within defined criteria for the authorization.

4       L:  (NAUTH) 17493 NAUTH Not Authorized

Authorization for specified healthcare service(s) and/or product(s) denied.

3     A: ActCoverageEligibilityConfirmationCode 17488

Indication of eligibility coverage for healthcare service(s) and/or product(s).

4       L:  (ELG) 17489 ELG Eligible

Insurance coverage is in effect for healthcare service(s) and/or product(s).

4       L:  (NELG) 17490 NELG Not Eligible

Insurance coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility.

2   A: ActCoverageLimitCode 17496

Criteria that are applicable to the authorized coverage.

3     L:  (COPAY) 17501 COPAY Co Pay Amount

The initial amount the policy holder is required to pay for the authorized product or service specified.

3     L:  (DEDUCT) 17500 DEDUCT Deductible Amount

The initial amount the payor is exempt from paying for the authorized product or service specified.

3     L:  (NETAMT) 17497 NETAMT Net Amount

Maximum net amount that will be covered for the product or service specified.

3     L:  (UNITPRICE) 17499 UNITPRICE Unit Price

Maximum unit price that will be covered for the authorized product or service.

3     L:  (UNITQTY) 17498 UNITQTY Unit Quantity

Maximum number of items that will be covered of the product or service specified.

2   A: ActDietCode 10376

Code set to define specialized/allowed diets

3     L:  (BR) 10379 BR breikost (GE)

A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat and digest.

3     L:  (DM) 10383 DM diabetes mellitus diet

A diet that uses carbohydrates sparingly. Typically with a restriction in daily energy content (e.g. 1600o2000 kcal.)

3     L:  (FAST) 10382 FAST fasting

No enteral intake of foot or liquids whatsoever, no smoking. Typically 6 to 8 hours before anesthesia.

3     L:  (GF) 10390 GF gluten free

Gluten free diet for celiac disease.

3     L:  (LF) 10386 LF low fat

A diet low in fat, particularly to patients with hepatic diseases.

3     L:  (LP) 10389 LP low protein

A low protein diet for patients with renal failure.

3     L:  (LQ) 10380 LQ liquid

A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may not contain fiber. Used before enteral surgeries.

3     L:  (LS) 10388 LS low sodium

A diet low in sodium for patients with congestive heart failure and/or renal failure.

3     L:  (N) 10377 N normal diet

A normal diet, i.e. no special preparations or restrictions for medical reasons. This is notwithstanding any preferences the patient might have regarding special foods, such as vegetarian, kosher, etc.

3     L:  (NF) 10387 NF no fat

A no fat diet for acute hepatic diseases.

3     L:  (PAF) 10391 PAF phenylalanine free

Phenylketonuria diet.

3     L:  (PAR) 10385 PAR parenteral

Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications.

3     L:  (RD) 10384 RD reduction diet

A diet that seeks to reduce body fat, typically low energy content (800o1600 kcal.)

3     L:  (SCH) 10378 SCH schonkost (GE)

A diet that avoids ingredients that might cause digestion problems, e.g., avoid excessive fat, avoid too much fiber (cabbage, peas, beans.)

3     L:  (T) 10381 T tea only

This is not really a diet, since it contains little nutritional value, but is essentially just water. Used before coloscopy examinations.

3     L:  (VLI) 10392 VLI low valine, leucine, isoleucine

Diet with low content of the amino-acids valin, leucin, and isoleucin, for "maple syrup disease."

2   A: ActEncounterAccommodationCode 16130

Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

3     L:  (I) 16134 I Isolation

Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission.

3     L:  (P) 16131 P Private

Accommodations in which there is only 1 bed.

3     L:  (S) 16133 S Suite

Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge.

3     L:  (SP) 16132 SP Semi-private

Accommodations in which there are 2 beds.

3     L:  (W) 16135 W Ward

Accommodations in which there are 3 or more beds.

2   A: ActEncounterCode 13955

Domain provides codes that qualify the ActEncounterClass (ENC)

3     S: ActInpatientEncounterCode (IMP) 16847 IMP inpatient encounter

An inpatient encounter is an encounter in which the patient is admitted to a hospital or equivalent facility.

4       L:  (ACUTE) 13956 ACUTE inpatient acute

An acute inpatient encounter.

4       L:  (NONAC) 16238 NONAC inpatient non-acute

Any category of inpatient encounter except 'acute'

3     A: ActMedicalServiceCode 17449

General category of medical service provided to the patient during their encounter.

4       L:  (ALC) 17459 ALC Alternative Level of Care

Provision of Alternate Level of Care to a patient in an acute bed. Patient is waiting for placement in a long-term care facility and is unable to return home.

4       L:  (CHR) 17453 CHR Chronic

Provision of recurring care for chronic illness.

4       L:  (DNTL) 17456 DNTL Dental

Provision of treatment for oral health and/or dental surgery.

4       L:  (DRGRHB) 17454 DRGRHB Drug Rehab

Provision of treatment for drug abuse.

4       L:  (MED) 17450 MED Medical

Provision of diagnostic and/or therapeutic treatment.

4       L:  (OBS) 17460 OBS Obstetrics

Provision of care of women during pregnancy, childbirth and immediate postpartum period. Also known as Maternity.

4       L:  (ONC) 17457 ONC Oncology

Provision of treatment and/or diagnosis related to tumors and/or cancer.

4       L:  (PALL) 17452 PALL Palliative

Provision of care for patients who are living or dying from an advanced illness.

4       L:  (PED) 17461 PED Paediatrics

Provision of diagnosis and treatment of diseases and disorders affecting children.

4       L:  (PHYRHB) 17455 PHYRHB Physical Rehab

Provision of treatment for physical injury.

4       L:  (PSYCH) 17458 PSYCH Psychicatric

Provision of treatment of psychiatric disorder relating to mental illness.

4       L:  (SURG) 17451 SURG Surgical

Provision of surgical treatment.

3     L:  (AMB) 16239 AMB ambulatory

An ambulatory encounter.

3     L:  (EMER) 16240 EMER emergency

An emergency encounter.

3     L:  (FLD) 16235 FLD field

Healthcare encounter that takes place outside a healthcare facility or home (e.g., helicopter, ambulance, accident site)

3     L:  (HH) 16237 HH home health

Healthcare encounter that takes place in the residence of the patient or a designee

3     L:  (VR) 16236 VR virtual

An interaction between a practitioner and patient (or patient's agent) where the communication does not take place in person

2   A: ActFinancialTransactionCode 14804
3     L:  (CHRG) 14805 CHRG Standard Charge

A type of transaction that represents a charge for a service or product. Expressed in monetary terms.

3     L:  (REV) 14806 REV Standard Charge Reversal

A type of transaction that represents a reversal of a previous charge for a service or product. Expressed in monetary terms. It has the opposite effect of a standard charge.

2   A: ActIncidentCode 16508

Set of codes indicating the type of incident or accident.

3     L:  (MVA) 16509 MVA Motor vehicle accident

Incident or accident is the result of a motor vehicle accident

3     L:  (SCH) 17468 SCH School Accident

Incident or accident is the result of a school place accident.

3     L:  (SPT) 17469 SPT Sporting Accident

Incident or accident is the result of a sporting accident.

3     L:  (WPA) 16510 WPA Workplace accident

Incident or accident is the result of a work place accident

2   A: ActInvoiceCode 17597

Type of invoice which will indicate to the payor te content rules to apply when processing and adjudicating the invoice.

3     L:  (CP) 17602 CP Clinical Product

Clinical product invoice.

3     L:  (CS) 17600 CS Clinical Service

Clinical services invoice.

3     L:  (PA) 17601 PA Preferred Accommodation

HealthCare facility preferred accommodation invoice.

3     L:  (RXC) 17599 RXC Rx Compound

Pharmacy dispense invoice for a compound.

3     L:  (RXD) 17598 RXD Rx Dispense

Pharmacy dispense invoice not involving a compound

2   A: ActInvoiceElementSummaryCode 17522

Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors.

3     A: InvoiceElementAdjudicated 17530

Total counts and total net amounts adjudicated for all root invoice elements that were adjudicated within a time period based on the adjudication date of the root invoice element.

4       L:  (ADCNPPELAT) 17552 ADCNPPELAT Adjudicated Cancelled Prior-Period Electronic Amou

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADCNPPELCT) 17551 ADCNPPELCT Adjudicated Cancelled Prior-Period Electronic Coun

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADCNPPMNAT) 17554 ADCNPPMNAT Adjudicated Cancelled Prior-Period Manual Amount

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADCNPPMNCT) 17553 ADCNPPMNCT Adjudicated Cancelled Prior-Period Manual Count

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADCNSPELAT) 17548 ADCNSPELAT Adjudicated Cancelled Same-Period Electronic Amoun

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADCNSPELCT) 17547 ADCNSPELCT adjud. cancelled same-period electronic count

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADCNSPMNAT) 17550 ADCNSPMNAT Adjudicated Cancelled Same-Period Manual Amount

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADCNSPMNCT) 17549 ADCNSPMNCT Adjudicated Cancelled Same-Period Manual Count

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADNPPPELAT) 17544 ADNPPPELAT adjud. non-payee payable prior-period electro

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPPPELCT) 17543 ADNPPPELCT adjud. non-payee payable prior-period electro

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPPPMNAT) 17546 ADNPPPMNAT Adjudicated Non-Payee Payable Prior-Period Manual

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPPPMNCT) 17545 ADNPPPMNCT Adjudicated Non-Payee Payable Prior-Period Manual

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPSPELAT) 17540 ADNPSPELAT adjud. non-payee payable same-period electron

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPSPELCT) 17539 ADNPSPELCT Adjudicated Non-Payee Payable Same-Period Electron

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPSPMNAT) 17542 ADNPSPMNAT Adjudicated Non-Payee Payable Same-Period Manual A

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPSPMNCT) 17541 ADNPSPMNCT Adjudicated Non-Payee Payable Same-Period Manual C

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADPPPPELAT) 17536 ADPPPPELAT Adjudicated Payee Payable Prior-Period Electronic

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPPPELCT) 17535 ADPPPPELCT Adjudicated Payee Payable Prior-Period Electronic

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPPPMNAT) 17538 ADPPPPMNAT Adjudicated Payee Payable Prior-Period Manual Amou

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPPPMNCT) 17537 ADPPPPMNCT Adjudicated Payee Payable Prior-Period Manual Coun

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPSPELAT) 17532 ADPPSPELAT Adjudicated Payee Payable Same-Period Electronic A

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPSPELCT) 17531 ADPPSPELCT Adjudicated Payee Payable Same-Period Electronic C

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPSPMNAT) 17534 ADPPSPMNAT Adjudicated Payee Payable Same-Period Manual Amoun

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPSPMNCT) 17533 ADPPSPMNCT Adjudicated Payee Payable Same-Period Manual Count

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADRFPPELAT) 17560 ADRFPPELAT Adjudicated Refused Prior-Period Electronic Amount

Identifies the total net amount of all root invoice elements that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFPPELCT) 17559 ADRFPPELCT Adjudicated Refused Prior-Period Electronic Count

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADRFPPMNAT) 17562 ADRFPPMNAT Adjudicated Refused Prior-Period Manual Amount

Identifies the total net amount of all root invoice elements that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFPPMNCT) 17561 ADRFPPMNCT Adjudicated Refused Prior-Period Manual Count

Identifies the total number of all root invoice elements that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFSPELAT) 17556 ADRFSPELAT adjud. refused same-period electronic amount

Identifies the total net amount of all root invoice elements that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFSPELCT) 17555 ADRFSPELCT Adjudicated Refused Same-Period Electronic Count

Identifies the total number of all root invoice elements that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFSPMNAT) 17558 ADRFSPMNAT Adjudicated Refused Same-Period Manual Amount

Identifies the total net amount of all root invoice elements that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFSPMNCT) 17557 ADRFSPMNCT Adjudicated Refused Same-Period Manual Count

Identifies the total number of all root invoice elements that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADCNPPELAT) 17552-1 ADCNPPELAT adjud. cancelled prior-period electronic amou

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADCNPPELCT) 17551-1 ADCNPPELCT adjud. cancelled prior-period electronic coun

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADCNPPMNAT) 17554-1 ADCNPPMNAT adjud. cancelled prior-period manual amount

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADCNPPMNCT) 17553-1 ADCNPPMNCT adjud. cancelled prior-period manual count

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADCNSPELAT) 17548-1 ADCNSPELAT adjud. cancelled same-period electronic amoun

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADCNSPELCT) 17547-1 ADCNSPELCT Adjudicated Cancelled Same-Period Electronic Count

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADCNSPMNAT) 17550-1 ADCNSPMNAT adjud. cancelled same-period manual amount

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADCNSPMNCT) 17549-1 ADCNSPMNCT adjud. cancelled same-period manual count

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADNPPPELAT) 17544-1 ADNPPPELAT Adjudicated Non-Payee Payable Prior-Period Electro

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPPPELCT) 17543-1 ADNPPPELCT Adjudicated Non-Payee Payable Prior-Period Electro

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPPPMNAT) 17546-1 ADNPPPMNAT adjud. non-payee payable prior-period manual

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPPPMNCT) 17545-1 ADNPPPMNCT adjud. non-payee payable prior-period manual

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPSPELAT) 17540-1 ADNPSPELAT Adjudicated Non-Payee Payable Same-Period Electron

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPSPELCT) 17539-1 ADNPSPELCT adjud. non-payee payable same-period electron

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPSPMNAT) 17542-1 ADNPSPMNAT adjud. non-payee payable same-period manual a

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPSPMNCT) 17541-1 ADNPSPMNCT adjud. non-payee payable same-period manual c

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADPPPPELAT) 17536-1 ADPPPPELAT adjud. payee payable prior-period electronic

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPPPELCT) 17535-1 ADPPPPELCT adjud. payee payable prior-period electronic

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPPPMNAT) 17538-1 ADPPPPMNAT adjud. payee payable prior-period manual amou

Identifies the total net amount of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPPPMNCT) 17537-1 ADPPPPMNCT adjud. payee payable prior-period manual coun

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPSPELAT) 17532-1 ADPPSPELAT adjud. payee payable same-period electronic amount

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPSPELCT) 17531-1 ADPPSPELCT adjud. payee payable same-period electronic count

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPSPMNAT) 17534-1 ADPPSPMNAT adjud. payee payable same-period manual amoun

Identifies the total net amount of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPSPMNCT) 17533-1 ADPPSPMNCT adjud. payee payable same-period manual count

Identifies the total number of all root invoice elements that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADRFPPELAT) 17560-1 ADRFPPELAT adjud. refused prior-period electronic amount

Identifies the total net amount of all root invoice elements that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFPPELCT) 17559-1 ADRFPPELCT adjud. refused prior-period electronic count

Identifies the total number of all root invoice elements that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADRFPPMNAT) 17562-1 ADRFPPMNAT adjud. refused prior-period manual amount

Identifies the total net amount of all root invoice elements that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFPPMNCT) 17561-1 ADRFPPMNCT adjud. refused prior-period manual count

Identifies the total number of all root invoice elements that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFSPELAT) 17556-1 ADRFSPELAT Adjudicated Refused Same-Period Electronic Amount

Identifies the total net amount of all root invoice elements that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFSPELCT) 17555-1 ADRFSPELCT adjud. refused same-period electronic count

Identifies the total number of all root invoice elements that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFSPMNAT) 17558-1 ADRFSPMNAT adjud. refused same-period manual amount

Identifies the total net amount of all root invoice elements that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFSPMNCT) 17557-1 ADRFSPMNCT adjud. refused same-period manual count

Identifies the total number of all root invoice elements that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

3     A: InvoiceElementPaid 17563

Total counts and total net amounts paid for all root invoice elements that were paid within a time period based on the payment date.

4       L:  (PDCNPPELAT) 17585 PDCNPPELAT Paid Cancelled Prior-Period Electronic Amount

Identifies the total net amount of all root invoice elements that were paid prior to the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (PDCNPPELCT) 17584 PDCNPPELCT Paid Cancelled Prior-Period Electronic Count

Identifies the total number of all root invoice elements that were paid prior to the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (PDCNPPMNAT) 17587 PDCNPPMNAT Paid Cancelled Prior-Period Manual Amount

Identifies the total net amount of all root invoice elements that were paid prior to the specified time period (based on payment date), subsequently cancelled in the specified period and submitted manually.

4       L:  (PDCNPPMNCT) 17586 PDCNPPMNCT Paid Cancelled Prior-Period Manual Count

Identifies the total number of all root invoice elements that were paid prior to the specified time period (based on payment date), subsequently cancelled in the specified period and submitted manually.

4       L:  (PDCNSPELAT) 17581 PDCNSPELAT Paid Cancelled Same-Period Electronic Amount

Identifies the total net amount of all root invoice elements that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (PDCNSPELCT) 17580 PDCNSPELCT Paid Cancelled Same-Period Electronic Count

Identifies the total number of all root invoice elements that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (PDCNSPMNAT) 17583 PDCNSPMNAT Paid Cancelled Same-Period Manual Amount

Identifies the total net amount of all root invoice elements that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted manually.

4       L:  (PDCNSPMNCT) 17582 PDCNSPMNCT Paid Cancelled Same-Period Manual Count

Identifies the total number of all root invoice elements that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted manually.

4       L:  (PDNPPPELAT) 17577 PDNPPPELAT Paid Non-Payee Payable Prior-Period Electronic Amo

Identifies the total net amount of all root invoice elements that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPPPELCT) 17576 PDNPPPELCT paid non-payee payable prior-period elect. count

Identifies the total number of all root invoice elements that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPPPMNAT) 17579 PDNPPPMNAT Paid Non-Payee Payable Prior-Period Manual Amount

Identifies the total net amount of all root invoice elements that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (PDNPPPMNCT) 17578 PDNPPPMNCT Paid Non-Payee Payable Prior-Period Manual Count

Identifies the total number of all root invoice elements that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (PDNPSPELAT) 17573 PDNPSPELAT Paid Non-Payee Payable Same-Period Electronic Amou

Identifies the total net amount of all root invoice elements that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPSPELCT) 17572 PDNPSPELCT Paid Non-Payee Payable Same-Period Electronic Coun

Identifies the total number of all root invoice elements that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPSPMNAT) 17575 PDNPSPMNAT Paid Non-Payee Payable Same-Period Manual Amount

Identifies the total net amount of all root invoice elements that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (PDNPSPMNCT) 17574 PDNPSPMNCT Paid Non-Payee Payable Same-Period Manual Count

Identifies the total number of all root invoice elements that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (PDPPPPELAT) 17569 PDPPPPELAT Paid Payee Payable Prior-Period Electronic Amount

Identifies the total net amount of all root invoice elements that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (PDPPPPELCT) 17568 PDPPPPELCT Paid Payee Payable Prior-Period Electronic Count

Identifies the total number of all root invoice elements that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (PDPPPPMNAT) 17571 PDPPPPMNAT Paid Payee Payable Prior-Period Manual Amount

Identifies the total net amount of all root invoice elements that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (PDPPPPMNCT) 17570 PDPPPPMNCT Paid Payee Payable Prior-Period Manual Count

Identifies the total number of all root invoice elements that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (PDPPSPELAT) 17565 PDPPSPELAT Paid Payee Payable Same-Period Electronic Amount

Identifies the total net amount of all root invoice elements that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (PDPPSPELCT) 17564 PDPPSPELCT Paid Payee Payable Same-Period Electronic Count

Identifies the total number of all root invoice elements that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (PDPPSPMNAT) 17567 PDPPSPMNAT Paid Payee Payable Same-Period Manual Amount

Identifies the total net amount of all root invoice elements that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (PDPPSPMNCT) 17566 PDPPSPMNCT Paid Payee Payable Same-Period Manual Count

Identifies the total number of all root invoice elements that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (PDNPPPELAT) 17577-1 PDNPPPELAT paid non-payee payable prior-period elect. amount

Identifies the total net amount of all root invoice elements that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPPPELCT) 17576-1 PDNPPPELCT Paid Non-Payee Payable Prior-Period Electronic Cou

Identifies the total number of all root invoice elements that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPSPELAT) 17573-1 PDNPSPELAT paid non-payee payable same-period elect. amount

Identifies the total net amount of all root invoice elements that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPSPELCT) 17572-1 PDNPSPELCT paid non-payee payable same-period elect. count

Identifies the total number of all root invoice elements that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

3     A: InvoiceElementSubmitted 17523

Total counts and total net amounts billed for all root invoice elements that were submitted within a time period. Adjudicated invoice elements are included.

4       L:  (SBBLAT) 17525 SBBLAT submitted billed electronic amount

Identifies the total net amount billed for all submitted root invoice elements within a time period. Adjudicated invoice elements are included.

4       L:  (SBBLCT) 17524 SBBLCT Submitted Billed Count

Identifies the total number of submitted root invoice elements within a time period and submitted electronically. Adjudicated invoice elements are included.

4       L:  (SBCNAT) 17527 SBCNAT Submitted Cancelled Amount

Identifies the total net amount billed for all submitted root invoice elements that were cancelled within a time period. Adjudicated invoice elements are included.

4       L:  (SBCNCT) 17526 SBCNCT submitted cancelled electronic count

Identifies the total number of submitted root invoice elements that were cancelled within a time period. Adjudicated invoice elements are included.

4       L:  (SBPDAT) 17529 SBPDAT submitted pending electronic amount

Identifies the total net amount billed for all submitted root invoice elements that are pended or held by the payor, within a time period. Adjudicated invoice elements are not included.

4       L:  (SBPDCT) 17528 SBPDCT Submitted Pending Count

Identifies the total number of submitted root invoice elements that are pended or held by the payor, within a time period. Adjudicated invoice elements are not included.

4       L:  (SBBLAT) 17525-1 SBBLAT Submitted Billed Amount

Identifies the total net amount billed for all submitted root invoice elements within a time period. Adjudicated invoice elements are included.

4       L:  (SBBLCT) 17524-1 SBBLCT submitted billed electronic count

Identifies the total number of submitted root invoice elements within a time period and submitted electronically. Adjudicated invoice elements are included.

4       L:  (SBCNAT) 17527-1 SBCNAT submitted cancelled electronic amount

Identifies the total net amount billed for all submitted root invoice elements that were cancelled within a time period. Adjudicated invoice elements are included.

4       L:  (SBCNCT) 17526-1 SBCNCT Submitted Cancelled Count

Identifies the total number of submitted root invoice elements that were cancelled within a time period. Adjudicated invoice elements are included.

4       L:  (SBPDAT) 17529-1 SBPDAT Submitted Pending Amount

Identifies the total net amount billed for all submitted root invoice elements that are pended or held by the payor, within a time period. Adjudicated invoice elements are not included.

4       L:  (SBPDCT) 17528-1 SBPDCT submitted pending electronic count

Identifies the total number of submitted root invoice elements that are pended or held by the payor, within a time period. Adjudicated invoice elements are not included.

2   A: ActInvoiceOverrideCode 17590

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

3     L:  (COVGE) 17594 COVGE Subscriber Coverage Problem

Insurance coverage problems have been encountered. Additional explanation information will supplied.

3     L:  (GFTH) 17592 GFTH Good Faith Indicator

The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered.

3     L:  (LATE) 17593 LATE Late Invoice

Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied.

3     L:  (OOJ) 18036 OOJ Out Of Jurisdiction Claimant

The medical service and/or product was provided to a patient that has coverage in another jurisdiction.

3     L:  (PYRDELAY) 17591 PYRDELAY Delayed by a Previous Payor

Allows provider to explain lateness of invoice to a subsequent payor.

3     L:  (REFNR) 18037 REFNR Referral Not Required

Rules of practice do not require a physician's referral for the provider to perform a billable service.

2   A: ActMonitoringProtocolCode 16231

Identifies types of monitoring programs

3     S: ControlledSubstanceMonitoringProtocol (CTLSUB) 16232 CTLSUB Controlled Substance

A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction.

2   A: ActPaymentCode 17610

Code identifying the method or the movement of payment instructions.

Codes are drawn from X12 data element 591 (PaymentMethodCode)

3     L:  (ACH) 17611 ACH Automated Clearing House

Automated Clearing House (ACH).

3     L:  (CHK) 17612 CHK Cheque

A written order to a bank to pay the amount specified from funds on deposit.

3     L:  (DDP) 17613 DDP Direct Deposit

Electronic Funds Transfer (EFT) deposit into the payee's bank account

3     L:  (NON) 17614 NON NonoPayment Data

NonoPayment Data.

2   A: ActPharmacySupplyType 16208

Identifies types of dispensing events

3     S: EmergencyPharmacySupplyType (EM) 16220 EM Emergency Supply

A supply action where there is no 'valid' order for the supplied medication. E.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription)

4       L:  (SO) 16221 SO Script Owing

An emergency supply where the expectation is that a formal order authorizing the supply will be provided at a later date.

3     S: FirstFillPharmacySupplyType (FF) 16209 FF First Fill

The initial fill against an order. (This includes initial fills against refill orders.)

4       L:  (DF) 16214 DF Daily Fill

A fill providing sufficient supply for one day

4       L:  (FFC) 16210 FFC First Fill - Complete

A first fill where the quantity supplied is equal to one full reptition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.)

4       L:  (FFP) 16211 FFP First Fill - Part Fill

A first fill where the quantity supplied is less than one full reptition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)

4       L:  (TF) 16212 TF Trial Fill

A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance.

4       L:  (UD) 16223 UD Unit Dose

A supply action that provides sufficient material for a single dose.

3     S: RefillPharmacySupplyType (RF) 16215 RF Refill

A fill against an order that has already been filled (or partially filled) at least once.

4       L:  (DF) 16214 DF Daily Fill

A fill providing sufficient supply for one day

4       L:  (RFC) 16216 RFC Refill - Complete

A refill where the quantity supplied is equal to one full reptition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.)

4       L:  (RFF) 16218 RFF Refill (First fill this facility)

The first fill against an order that has already been filled at least once at another facility.

4       L:  (RFP) 16217 RFP Refill - Part Fill

A refill where the quantity supplied is less than one full reptition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)

4       L:  (TB) 16213 TB Trial Balance

A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided.

4       L:  (UD) 16223 UD Unit Dose

A supply action that provides sufficient material for a single dose.

3     L:  (FS) 16222 FS Floor stock

A supply action to restock a smaller more local dispensary.

3     L:  (MS) 16219 MS Manufacturer Sample

A supply of a manufacturer sample

2   A: ActProcedureCode 16535

The type of procedure Act

2   A: ActProductAcquisitionCode 17958

The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods.

3     S: (TRANSFER) 17959 TRANSFER Transfer

Transfer of ownership for a product.

4       L:  (SALE) 17960 SALE Sale

Transfer of ownership for a product for financial compensation.

3     S: (LOAN) 17961 LOAN Loan

Temporary supply of a product without transfer of ownership for the product.

4       L:  (RENT) 17962 RENT Rent

Temporary supply of a product with financial compensation, without transfer of ownership for the product.

2   A: ActSpecimenTreatmentCode 14040

Set of codes related to specimen treatments

3     L:  (ACID) 14044 ACID Acidification

The lowering of specimen pH through the addition of an acid

3     L:  (ALK) 14046 ALK Alkalization

The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities.

3     L:  (DEFB) 14043 DEFB Defibrination

The removal of fibrin from whole blood or plasma through physical or chemical means

3     L:  (FILT) 14047 FILT Filtration

The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum (suction).

3     L:  (LDLP) 14041 LDLP LDL Precipitation
3     L:  (NEUT) 14045 NEUT Neutralization

The act or process by which an acid and a base are combined in such proportions that the resulting compound is neutral.

3     L:  (RECA) 14042 RECA Recalcification

The addition of calcium back to a specimen after it was removed by chelating agents

3     L:  (UFIL) 14048 UFIL Ultrafiltration

The filtration of a colloidal substance through a semipermeable medium that allows only the passage of small molecules.

2   A: ActSpecObsCode 13957

Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation

3     S: ActSpecObsDilutionCode (DILUTION) 14352 DILUTION ActSpecObsDilutionCode

An observation that reports the dilution of a sample.

4       L:  (AUTO-HIGH) 13958 AUTO-HIGH Auto-High Dilution

The dilution of a sample performed by automated equipment. The value is specified by the equipment

4       L:  (AUTO-LOW) 13959 AUTO-LOW Auto-Low Dilution

The dilution of a sample performed by automated equipment. The value is specified by the equipment

4       L:  (PRE) 13961 PRE Pre-Dilution

The dilution of the specimen made prior to being loaded onto analyticla equipment

4       L:  (RERUN) 13960 RERUN Rerun Dilution

The value of the dilution of a sample after it had been analyzed at a prior dilution value

3     S: ActSpecObsInterferenceCode (INTFR) 14382 INTFR ActSpecObsInterferenceCode

An observation that relates to factors that may potentially cause interference with the observation

4       L:  (FIBRIN) 14386 FIBRIN Fibrin

The Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, recommend using 0 and 1

4       L:  (HEMOLYSIS) 14383 HEMOLYSIS Hemolysis

An observation of the hemolysis index of the specimen in g/L

4       L:  (ICTERUS) 14385 ICTERUS Icterus

An observation that describes the icterus index of the specimen. It is recommended to use mMol/L of bilirubin

4       L:  (LIPEMIA) 14384 LIPEMIA Lipemia

An observation used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units).

3     S: ActSpecObsVolumeCode (VOLUME) 14369 VOLUME ActSpecObsVolumeCode

An observation that reports the volume of a sample.

4       L:  (AVAILABLE) 13963 AVAILABLE Available Volume

The available quantity of specimen. This is the current quantity minus any planned consumption (e.g., tests that are planned)

4       L:  (CONSUMPTION) 13965 CONSUMPTION Consumption Volume

The quantity of specimen that is used each time the equipment uses this substance

4       L:  (CURRENT) 13962 CURRENT Current Volume

The current quantity of the specimen, i.e., initial quantity minus what has been actually used.

4       L:  (INITIAL) 13964 INITIAL Initial Volume

The initial quantity of the specimen in inventory

3     L:  (ARTBLD) 14387 ARTBLD ActSpecObsArtBldCode

Describes the artificial blood identifier that is associated with the specimen.

3     L:  (EVNFCTS) 14390 EVNFCTS ActSpecObsEvntfctsCode

Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors)

2   A: ROIOverlayShape 16117

Shape of the region on the object being referenced

3     L:  (CIRCLE) 16118 CIRCLE circle

A circle defined by two (column,row) pairs. The first point is the center of the circle and the second point is a point on the perimeter of the circle.

3     L:  (ELLIPSE) 16119 ELLIPSE ellipse

An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints of the major axis and the second two points specifying the endpoints of the minor axis.

3     L:  (POINT) 16120 POINT point

A single point denoted by a single (column,row) pair, or multiple points each denoted by a (column,row) pair.

3     L:  (POLY) 16121 POLY polyline

A series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon.

2   A: SubstanceAdministrationActCode 16532

The specific chemical or radiological substance administered or to be administered into the body for therapeutic effect.

3     A: ClinicalDrug 16205

Any substance or mixture of substances manufactured, sold or represented for use in: (a) the diagnosis, treatment, mitigation or prevention of a disease, disorder, abnormal physical state, or its symptoms, in human beings or animals; (b) restoring, correcting or modifying organic functions in human beings or animals.

4       A: ManufacturedDrug 16206

Identifies a drug or the use of a drug as produced by a specific manufacturer

2   A: x_ActFinancialProductAcquisitionCode 17963

The method that a product is obtained for use by the subject of the supply act (e.g. patient), with financial compensation. Product examples are consumable or durable goods.

3     L:  (RENT) 17962 RENT Rent

Temporary supply of a product with financial compensation, without transfer of ownership for the product.

3     L:  (SALE) 17960 SALE Sale

Transfer of ownership for a product for financial compensation.

1 A: ObservationType 16226

Identifies the kinds of observations that can be performed

2   A: LogicalObservationIdentifierNamesAndCodes 16492

The LOINC database provides a set of universal names and ID codes for identifying laboratory and clinical test results. The purpose is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research. The LOINC codes are not intended to transmit all possible information about a test or observation. They are only intended to identify the test result or clinical observation. http://www.regenstrief.org/LOINC/LOINC.htm

2   A: ObservationDiagnosisTypes 16228

An observation about the presence (or absense) of a particular disease state in a subject.

3     L:  (ADMDX) 16839 ADMDX admitting diagnosis

Admitting diagnosis are the diagnoses documented for administrative purposes as the basis for a hospital admission.

3     L:  (DISDX) 16840 DISDX discharge diagnosis

Discharge diagnosis are the diagnoses documented for administrative purposes as the time of hospital discharge.

3     L:  (INTDX) 16841 INTDX intermediate diagnosis

Intermediate diagnoses are those diagnoses documented for administrative purposes during the course of a hospital stay.

2   L:  (SEV) 16642 SEV Severity Observation

Indicates a subjective evaluation of the criticality associated with another observation.


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