SV6 Anesthesia Service

To specify the claim service detail for anesthesia

Position
Element
Name
Type
Requirement
Min
Max
Repeat
SV601
Composite Medical Procedure Identifier
Composite (composite)
Mandatory
1
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)
02
Product/Service ID
String (AN)
Mandatory
1
48
-
Identifying number for a product or service
03
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
C003-03 modifies the value in C003-02.
04
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
C003-04 modifies the value in C003-02.
05
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
C003-05 modifies the value in C003-02.
06
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
C003-06 modifies the value in C003-02.
07
Description
String (AN)
Optional
1
80
-
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.
SV602
Facility Code Qualifier
Identifier (ID)
Conditional
1
2
1
Code identifying the type of facility referenced
P0203: If either SV6-02 or SV6-03 is present, then the other is required
SV603
Facility Code Value
String (AN)
Conditional
1
2
1
Code identifying the type of facility where services were performed; the first and second positions of the Uniform Bill Type code or the Place of Service code from the Electronic Media Claims National Standard Format
SV604
Monetary Amount
Decimal number (R)
Optional
1
18
1
Monetary amount
SV604 is the submitted charge.
SV605
Composite Diagnosis Code Pointer
Composite (composite)
Optional
1
01
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.
02
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.
03
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.
04
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.
SV606
Quantity
Decimal number (R)
Optional
1
15
1
Numeric value of quantity
SV606 is the number of anesthesia minutes.
SV607
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
1
Code indicating a Yes or No condition or response
SV607 is the Certified Registered Nurse Anesthetist (CRNA) supervision indicator. A "Y" value indicates that services were performed personally by a CRNA who was medically directed by a physician other than the operating surgeon, assistant surgeon, or attending physician; an "N" value indicates that the services were performed personally by a CRNA who was medically directed by the operating surgeon, assistant surgeon, or attending physician.

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