UB2
UB92 Data
The UB2 segment contains data necessary to complete UB92 bills specific to the United States; other realms may choose to implement using regional code sets. Only UB92 fields that do not exist in other HL7 defined segments appear in this segment. For example, Patient Name and Date of Birth are required; they are included in the PID segment and therefore do not appear here. UB92 field locators are provided in parentheses ( ). The UB codes listed as examples are not an exhaustive or current list; refer to a UB specification for additional information.
The Uniform Billing segments are specific to the US and may not be implemented in non-US systems.
RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler
17
| C.Len | Element | v2.5 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ..4 | - | SI | O | 1 | - | 00553 | UB2-1 | Set ID - UB2 | |
| 2 | ..3 | - | ST | O | 1 | - | 00554 | UB2-2 | Co-Insurance Days (9) | |
| 3 | ..2 | - | IS | O | 7 | 0043 | 00555 | UB2-3 | Condition Code (24-30) | Repetition |
| 4 | ..3 | - | ST | O | 1 | - | 00556 | UB2-4 | Covered Days (7) | |
| 5 | ..4 | - | ST | O | 1 | - | 00557 | UB2-5 | Non-Covered Days (8) | |
| 6 | ..41 | - | UVC | O | 12 | - | 00558 | UB2-6 | Value Amount & Code | Repetition |
| 7 | ..259 | - | OCD | O | 8 | - | 00559 | UB2-7 | Occurrence Code & Date (32-35) | Repetition |
| 8 | ..268 | - | OSP | O | 2 | - | 00560 | UB2-8 | Occurrence Span Code/Dates (36) | Repetition |
| 9 | ..29 | - | ST | O | 2 | - | 00561 | UB2-9 | UB92 Locator 2 (State) | Repetition |
| 10 | ..12 | - | ST | O | 2 | - | 00562 | UB2-10 | UB92 Locator 11 (State) | Repetition |
| 11 | ..5 | - | ST | O | 1 | - | 00563 | UB2-11 | UB92 Locator 31 (National) | |
| 12 | ..23 | - | ST | O | 3 | - | 00564 | UB2-12 | Document Control Number | Repetition |
| 13 | ..4 | - | ST | O | 23 | - | 00565 | UB2-13 | UB92 Locator 49 (National) | Repetition |
| 14 | ..14 | - | ST | O | 5 | - | 00566 | UB2-14 | UB92 Locator 56 (State) | Repetition |
| 15 | ..27 | - | ST | O | 1 | - | 00567 | UB2-15 | UB92 Locator 57 (National) | |
| 16 | ..2 | - | ST | O | 2 | - | 00568 | UB2-16 | UB92 Locator 78 (State) | Repetition |
| 17 | ..3 | - | NM | O | 1 | - | 00815 | UB2-17 | Special Visit Count |
6