C004 Composite Diagnosis Code Pointer

To identify one or more diagnosis code pointers

Position
Element
Name
Type
Requirement
Min
Max
Repeat
C00401
Diagnosis Code Pointer
Numeric (N0)
Mandatory
1
2
-
A pointer to the claim diagnosis code in the order of importance to this service
C004-01 identifies the primary diagnosis code for this service line.
C00402
Diagnosis Code Pointer
Numeric (N0)
Optional
1
2
-
A pointer to the claim diagnosis code in the order of importance to this service
C004-02 identifies the second diagnosis code for this service line.
C00403
Diagnosis Code Pointer
Numeric (N0)
Optional
1
2
-
A pointer to the claim diagnosis code in the order of importance to this service
C004-03 identifies the third diagnosis code for this service line.
C00404
Diagnosis Code Pointer
Numeric (N0)
Optional
1
2
-
A pointer to the claim diagnosis code in the order of importance to this service
C004-04 identifies the fourth diagnosis code for this service line.

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