PSL

Product/Service Line Item

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2.5.1May2007

2.6Sep2007

2.7Jan2011

...

The Product/Service Line Item segment is used to identify individual product/service items that typically are aggregated into an Invoice. Each instance of a Product/Service Line Item corresponds to a unique product delivered or service rendered.

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

		C.Len						Element		v2.5
1	..73	-	EI	R	1	-	01955	PSL-1	Provider Product/Service Line Item Number	NEW
2	..73	-	EI	O	1	-	01956	PSL-2	Payer Product/Service Line Item Number	NEW
3	..4	-	SI	R	1	-	01957	PSL-3	Product/Service Line Item Sequence Number	NEW
4	..20	-	EI	O	1	-	01958	PSL-4	Provider Tracking ID	NEW
5	..20	-	EI	O	1	-	01959	PSL-5	Payer Tracking ID	NEW
6	..2	-	CWE	R	1	0559	01960	PSL-6	Product/Service Line Item Status	NEW
7	..177	-	CWE	R	1	0879	01961	PSL-7	Product/Service Code	NEW
8	..177	-	CWE	O	5	0880	01962	PSL-8	Product/Service Code Modifier	NEW
9	..80	-	ST	O	1	-	01963	PSL-9	Product/Service Code Description	NEW
10	..24	-	DTM	C	1	-	01964	PSL-10	Product/Service Effective Date	NEW
11	..24	-	DTM	O	1	-	01965	PSL-11	Product/Service Expiration Date	NEW
12	..222	-	CQ	C	1	0560	01966	PSL-12	Product/Service Quantity	NEW
13	..254	-	CP	C	1	-	01967	PSL-13	Product/Service Unit Cost	NEW
14	..10	-	NM	C	1	-	01968	PSL-14	Number of Items per Unit	NEW
15	..254	-	CP	C	1	-	01969	PSL-15	Product/Service Gross Amount	NEW
16	..254	-	CP	C	1	-	01970	PSL-16	Product/Service Billed Amount	NEW
17	..10	-	IS	O	20	0561	01971	PSL-17	Product/Service Clarification Code Type	NEW
18	..40	-	ST	O	20	-	01972	PSL-18	Product/Service Clarification Code Value	NEW
19	..73	-	EI	O	5	-	01973	PSL-19	Health Document Reference Identifier	NEW
20	..10	-	IS	O	20	0562	01974	PSL-20	Processing Consideration Code	NEW
21	..2	-	ID	R	1	0532	01975	PSL-21	Restricted Disclosure Indicator	NEW
22	..177	-	CWE	O	1	0879	01976	PSL-22	Related Product/Service Code Indicator	NEW
23	..254	-	CP	O	1	-	01977	PSL-23	Product/Service Amount for Physician	NEW
24	..5	-	NM	O	1	-	01978	PSL-24	Product/Service Cost Factor	NEW
25	..250	-	CX	O	1	-	01933	PSL-25	Cost Center	NEW
26	..49	-	DR	O	1	-	01980	PSL-26	Billing Period	NEW
27	..5	-	NM	O	1	-	01981	PSL-27	Days without Billing	NEW
28	..4	-	NM	O	1	-	01982	PSL-28	Session-No	NEW
29	..20	-	XCN	O	1	-	01983	PSL-29	Executing Physician ID	NEW
30	..20	-	XCN	O	1	-	01984	PSL-30	Responsible Physician ID	NEW
31	..10	-	CWE	O	1	0881	01985	PSL-31	Role Executing Physician	NEW
32	..10	-	CWE	O	1	0882	01986	PSL-32	Medical Role Executing Physician	NEW
33	..3	-	CWE	O	1	0894	01987	PSL-33	Side of body	NEW
34	..6	-	NM	O	1	-	01988	PSL-34	Number of TP's PP	NEW
35	..6	-	CP	O	1	-	01989	PSL-35	TP-Value PP	NEW
36	..4	-	NM	O	1	-	01990	PSL-36	Internal Scaling Factor PP	NEW
37	..4	-	NM	O	1	-	01991	PSL-37	External Scaling Factor PP	NEW
38	..7	-	CP	O	1	-	01992	PSL-38	Amount PP	NEW
39	..6	-	NM	O	1	-	01993	PSL-39	Number of TP's Technical Part	NEW
40	..6	-	CP	O	1	-	01994	PSL-40	TP-Value Technical Part	NEW
41	..4	-	NM	O	1	-	01995	PSL-41	Internal Scaling Factor Technical Part	NEW
42	..4	-	NM	O	1	-	01996	PSL-42	External Scaling Factor Technical Part	NEW
43	..7	-	CP	O	1	-	01997	PSL-43	Amount Technical Part	NEW
44	..8	-	CP	O	1	-	01998	PSL-44	Total Amount Professional Part + Technical Part	NEW
45	..3	-	NM	O	1	-	01999	PSL-45	VAT-Rate	NEW
46	..20	-	ID	O	1	-	02000	PSL-46	Main-Service	NEW
47	..1	-	ID	O	1	0136	02001	PSL-47	Validation	NEW
48	..255	-	ST	O	1	-	02002	PSL-48	Comment	NEW