UB2

UB92 data

...

2.2Nov1994

2.3Apr1997

2.3.1May1999

...

The UB2 segment contains data necessary to complete UB92 bills. Only UB92 fields that do not exist in other HL7 defined segments 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. When the field locators are different on the UB92, as compared to the UB82, the element is listed with its new location in parentheses ( ).

Figure 6-11. UB2 attributes

RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler

		C.Len						Element		v2.2
1	..4	-	SI	O	1	-	00553	UB2-1	Set ID - UB2	2
2	..3	-	ST	O	1	-	00554	UB2-2	Co-Insurance Days (9)	2
3	..2	-	ID	O	7	0043	00555	UB2-3	Condition Code (24-30)	2
4	..3	-	ST	O	1	-	00556	UB2-4	Covered Days (7)	2
5	..4	-	ST	O	1	-	00557	UB2-5	Non-Covered Days (8)	2
6	..11	-	CM_UVC	O	12	-	00558	UB2-6	Value Amount & Code	2
7	..11	-	CM_OCD	O	8	-	00559	UB2-7	Occurrence Code & Date (32-35)	2
8	..28	-	CM_OSP	O	2	-	00560	UB2-8	Occurrence Span Code/Dates (36)	2
9	..29	-	ST	O	2	-	00561	UB2-9	UB92 Locator 2 (State)	2
10	..12	-	ST	O	2	-	00562	UB2-10	UB92 Locator 11 (State)	2
11	..5	-	ST	O	1	-	00563	UB2-11	UB92 Locator 31 (National)	2
12	..23	-	ST	O	3	-	00564	UB2-12	Document Control Number	2
13	..4	-	ST	O	23	-	00565	UB2-13	UB92 Locator 49 (National)	2
14	..14	-	ST	O	5	-	00566	UB2-14	UB92 Locator 56 (State)	2
15	..27	-	ST	O	1	-	00567	UB2-15	UB92 Locator 57 (National)	2
16	..2	-	ST	O	2	-	00568	UB2-16	UB92 Locator 78 (State)	2
17	..3	-	NM	O	1	-	00815	UB2-17	Special Visit Count	NEW