UB2
UB92 DATA
The UB2 segment contains data necessary to complete UB92 bills. Only UB92 data elements that do not exist in other HL7 defined segments will appear in this segment. Just as with the UB82 billing, Patient Name and Date of Birth are required, they are included in the PID segment and therefore do not appear here. Where the field locators are different on the UB92, when compared to the UB82, the element is listed with its new location in parentheses ().
Figure 6-10 UB2 attributes
RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler
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| C.Len | Element | v2.1 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ..4 | - | SI | O | 1 | - | 00553 | UB2-1 | Set ID - UB92 | NEW |
| 2 | ..3 | - | ST | O | 1 | - | 00554 | UB2-2 | Co-insurance days (9) | NEW |
| 3 | ..2 | - | ID | O | 7 | 0043 | 00555 | UB2-3 | Condition code (24-30) | NEW |
| 4 | ..3 | - | ST | O | 1 | - | 00556 | UB2-4 | Covered days (7) | NEW |
| 5 | ..4 | - | ST | O | 1 | - | 00557 | UB2-5 | Non-covered days (8) | NEW |
| 6 | ..11 | - | CM_UVC | O | 12 | - | 00558 | UB2-6 | Value amount and code (39-41) | NEW |
| 7 | ..11 | - | CM_OCD | O | 8 | - | 00559 | UB2-7 | Occurrence code and date (32-35) | NEW |
| 8 | ..28 | - | CM_OSP | O | 2 | - | 00560 | UB2-8 | Occurrence span code / dates (36) | NEW |
| 9 | ..29 | - | ST | O | 2 | - | 00561 | UB2-9 | UB92 locator 2 (state) | NEW |
| 10 | ..12 | - | ST | O | 2 | - | 00562 | UB2-10 | UB92 locator 11 (state) | NEW |
| 11 | ..5 | - | ST | O | 1 | - | 00563 | UB2-11 | UB92 locator 31 (national) | NEW |
| 12 | ..23 | - | ST | O | 3 | - | 00564 | UB2-12 | Document control number (37) | NEW |
| 13 | ..4 | - | ST | O | 23 | - | 00565 | UB2-13 | UB92 locator 49 (national) | NEW |
| 14 | ..14 | - | ST | O | 5 | - | 00566 | UB2-14 | UB92 locator 56 (state) | NEW |
| 15 | ..27 | - | ST | O | 1 | - | 00567 | UB2-15 | UB92 locator 57 (national) | NEW |
| 16 | ..2 | - | ST | O | 2 | - | 00568 | UB2-16 | UB92 Locator 78 (state) | NEW |
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