01971
Product/Service Clarification Code Type
2013-03-10
Definition: Additional codes describing the Product/Service Code on PSL - examples are Northern Allowance, Data Center Numbers, Sequence Numbers; repeats with Product/Service Clarification Code Value. Refer to User-defined Table 0561 - Product/Services Clarification Codes for suggested values.
LengthNot specified
7 values
CLCTR | Claim Center |
DGAPP | Diagnostic Approval Number(MSP: assigned by MSP) |
DTCTR | Data Center Number(MSP: Data Center Number associated with the Provider's Network Application ID) |
ENC | Encounter Number |
GFTH | Good Faith Indicator |
OOP | Out of Province Indicator |
SEQ | Sequence Number(MSP: Must be sequential by Data Center Number) |
22 components
| 1 | O | - | Identifier | |
| 2 | O | - | Text | |
| 3 | C | Name of Coding System | ||
| 4 | O | - | Alternate Identifier | |
| 5 | O | - | Alternate Text | |
| 6 | C | Name of Alternate Coding System | ||
| 7 | C | - | Coding System Version ID | |
| 8 | O | - | Alternate Coding System Version ID | |
| 9 | O | - | Original Text | |
| 10 | O | - | Second Alternate Identifier | |
| 11 | O | - | Second Alternate Text | |
| 12 | C | Name of Second Alternate Coding System | ||
| 13 | O | - | Second Alternate Coding System Version ID | |
| 14 | C | - | Coding System OID | |
| 15 | O | - | Value Set OID | |
| 16 | C | - | Value Set Version ID | |
| 17 | C | - | Alternate Coding System OID | |
| 18 | O | - | Alternate Value Set OID | |
| 19 | C | - | Alternate Value Set Version ID | |
| 20 | C | - | Second Alternate Coding System OID | |
| 21 | O | - | Second Alternate Value Set OID | |
| 22 | C | - | Second Alternate Value Set Version ID |