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