SV5 Durable Medical Equipment Service

To specify the claim service detail for durable medical equipment

Position
Element
Name
Type
Requirement
Min
Max
Repeat
SV5-01
Product/Service ID Qualifier
Identifier (ID)
Mandatory
2
2
-
Code identifying the type/source of the descriptive number used in Product/Service ID (234).
SV5-02
Product/Service ID
String (AN)
Mandatory
1
30
-
Identifying number for a product or service.
SV5-03
Unit or Basis for Measurement Code
Identifier (ID)
Mandatory
2
2
-
Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken
SV5-04
Quantity
Decimal number (R)
Mandatory
1
15
-
Numeric value of quantity.
SV504 is length of medical treatment required.
SV5-05
Monetary Amount
Decimal number (R)
Conditional
1
15
-
Monetary amount.
R0506: At least one of SV5-05 or SV5-06 is required
SV505 is rental price.
SV5-06
Monetary Amount
Decimal number (R)
Conditional
1
15
-
Monetary amount.
SV506 is purchase price.

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