BLI Billable information

To provide billable information for a claim or encounter.

Position
Element
Name
Type
Requirement
Min
Max
Repeat
010
Monetary amount
Numeric (N)
Conditional
1
35
3
To specify a monetary amount.
020
Diagnosis
Composite (composite)
Conditional
9
010
Product identifier
String (AN)
Mandatory
1
35
-
To identify a product.
020
Diagnosis type code
String (AN)
Conditional
1
3
-
Code specifying the type of diagnosis.
030
Code list identification code
String (AN)
Conditional
1
17
-
Code identifying a user or association maintained code list.
1 The codes for this data element are provided by the code list responsible agency defined in data element 3055.
030
Date/time/period
Composite (composite)
Conditional
9
010
Date or time or period function code qualifier
String (AN)
Mandatory
1
3
-
Code qualifying the function of a date, time or period.
020
Date or time or period text
String (AN)
Conditional
1
35
-
The value of a date, a date and time, a time or of a period in a specified representation.
030
Date or time or period format code
String (AN)
Conditional
1
3
-
Code specifying the representation of a date, time or period.
040
Object identifier
String (AN)
Conditional
1
35
5
Code specifying the unique identity of an object.
050
Yes or no indicator code
String (AN)
Conditional
1
3
3
Code specifying either a yes or no.
060
Related cause
Composite (composite)
Conditional
9
010
Related cause code
String (AN)
Conditional
1
3
-
Code specifying a related cause.
020
Date
String (AN)
Conditional
1
14
-
To specify a date.
030
Country subdivision identifier
String (AN)
Conditional
1
9
-
To identify a country subdivision, such as state, canton, county, prefecture.
1 Recommended use ISO 3166-2. If not applicable, use appropriate code set defined by appropriate national authority.

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