SV2 Institutional Service

To specify the service line item detail for a health care institution

Position: SV2-01 · Element: 234 · Name: Product/Service ID · Type: String (AN) · Requirement: Conditional · Min: 1 · Max: 80 · Repeat: 1

Identifying number for a product or service

R0102: At least one of SV2-01 or SV2-02 is required

SV201 is the revenue code.

SV2-02 C003 Composite Medical Procedure Identifier Composite (composite) Conditional 1

Position: 01 · Element: 235 · Name: Product/Service ID Qualifier · Type: Identifier (ID) · Requirement: Mandatory · Min: 2 · Max: 2 · Repeat: -

Code identifying the type/source of the descriptive number used in Product/Service ID (234)

C003-01 qualifies C003-02 and C003-08.

Position: 02 · Element: 234 · Name: Product/Service ID · Type: String (AN) · Requirement: Mandatory · Min: 1 · Max: 80 · Repeat: -

Identifying number for a product or service

If C003-08 is used, then C003-02 represents the beginning value in the range in which the code occurs.

Position: 03 · Element: 1339 · Name: Procedure Modifier · Type: String (AN) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

This identifies special circumstances related to the performance of the service, as defined by trading partners

C003-03 modifies the value in C003-02 and C003-08.

Position: 04 · Element: 1339 · Name: Procedure Modifier · Type: String (AN) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

This identifies special circumstances related to the performance of the service, as defined by trading partners

C003-04 modifies the value in C003-02 and C003-08.

Position: 05 · Element: 1339 · Name: Procedure Modifier · Type: String (AN) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

This identifies special circumstances related to the performance of the service, as defined by trading partners

C003-05 modifies the value in C003-02 and C003-08.

Position: 06 · Element: 1339 · Name: Procedure Modifier · Type: String (AN) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

This identifies special circumstances related to the performance of the service, as defined by trading partners

C003-06 modifies the value in C003-02 and C003-08.

Position: 07 · Element: 352 · Name: Description · Type: String (AN) · Requirement: Optional · Min: 1 · Max: 80 · Repeat: -

A free-form description to clarify the related data elements and their content

C003-07 is the description of the procedure identified in C003-02.

Position: 08 · Element: 234 · Name: Product/Service ID · Type: String (AN) · Requirement: Optional · Min: 1 · Max: 80 · Repeat: -

Identifying number for a product or service

C003-08 represents the ending value in the range in which the code occurs.

Position: 09 · Element: 1339 · Name: Procedure Modifier · Type: String (AN) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

This identifies special circumstances related to the performance of the service, as defined by trading partners

C003-09 modifies the value in C003-02 and C003-08.

Position: 10 · Element: 1339 · Name: Procedure Modifier · Type: String (AN) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

This identifies special circumstances related to the performance of the service, as defined by trading partners

C003-10 modifies the value in C003-02 and C003-08.

Position: 11 · Element: 1339 · Name: Procedure Modifier · Type: String (AN) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

This identifies special circumstances related to the performance of the service, as defined by trading partners

C003-11 modifies the value in C003-02 and C003-08.

Position: 12 · Element: 1339 · Name: Procedure Modifier · Type: String (AN) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

This identifies special circumstances related to the performance of the service, as defined by trading partners

C003-12 modifies the value in C003-02 and C003-08.

Position: SV2-03 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 18 · Repeat: 1

Monetary amount

SV203 is the submitted service line item amount.

Position: SV2-04 · Element: 355 · Name: Unit or Basis for Measurement Code · Type: Identifier (ID) · Requirement: Conditional · Min: 2 · Max: 2 · Repeat: 1

Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken

P0405: If either SV2-04 or SV2-05 is present, then the other is required

Position: SV2-05 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Conditional · Min: 1 · Max: 15 · Repeat: 1

Numeric value of quantity

Position: SV2-06 · Element: 1371 · Name: Unit Rate · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 10 · Repeat: 1

The rate per unit of associate revenue for hospital accommodation

Position: SV2-07 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 18 · Repeat: 1

Monetary amount

SV207 is a non-covered service amount.

Position: SV2-08 · Element: 1073 · Name: Yes/No Condition or Response Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: 1

Code indicating a Yes or No condition or response

SV208 is the detail service line indicator. A "Y" value indicates a detail service line; an "N" value indicates a summary service line.

Position: SV2-09 · Element: 1345 · Name: Nursing Home Residential Status Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: 1

Code specifying the status of a nursing home resident at the time of service

Position: SV2-10 · Element: 1337 · Name: Level of Care Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: 1

Code specifying the level of care provided by a nursing home facility

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