| 01 | Pre-existing Conditions Disease that existed prior to a person's effective date of coverage |
| 02 | Diagnosis Cause of the patient complaint |
| 03 | Condition Diagnosis for which the patient will be confined in a health care facility |
| 04 | Occurrence Episode defining a significant event |
| 05 | Occurrence Span Several episodes over a period of time |
| 06 | Value |
| 07 | Ambulance Certification |
| 08 | Chiropractic Certification Reasons why chiropractic care is just and appropriate treatment |
| 09 | Durable Medical Equipment Certification Prescription describing the need for durable medical equipment; usually included are the diagnosis and estimated duration of need |
| 10 | Enteral or Parenteral Therapy Certification |
| 11 | Oxygen Therapy Certification |
| 12 | Admitting Diagnosis Condition for which the patient will be confined in a health care facility |
| 13 | Principal Diagnosis Condition established after study to be chiefly responsible for the patient's complaint |
| 14 | Pre-Existing Physical Condition Any physical condition that exists prior to the effective date of coverage under a contract |
| 15 | Pre-Existing Mental Condition Any mental condition that exists prior to the effective date of coverage under a contract |
| 16 | Routine Foot Care Class Finding |
| 17 | Systemic Condition for Routine Foot Care |
| 18 | Co-op Advertising |
| 19 | Commercial Advertising |
| 20 | Specimen Kit Type Code |
| 21 | Laboratory Test Condition Code |
| 22 | Automobile Loss |
| 23 | Laboratory Results Identification Code |
| 24 | Line of Business Code |
| 25 | United States Department of Vital Statistics E-Code A code used to identify conditions related to this bill that may affect payor processing |
| 26 | Employment Status Information |
| 27 | Income |
| 28 | Loan Information |
| 29 | Injury or Illness |
| 30 | Benefit Adjustment |
| 31 | Claimant |
| 32 | Contractholder Branch |
| 33 | Contractholder |
| 34 | Secondary Claim Administrator |
| 35 | Primary Claim Administrator |
| 36 | Reporting Agency |
| 37 | Process |
| 38 | Hazardous Material |
| 39 | Activity |
| 40 | Accident |
| 41 | Initial Treatment |
| 42 | Cause of Injury |
| 43 | Part of Body |
| 44 | Nature of Injury |
| 45 | Source of Injury |