UB2

Uniform Billing Data

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2.6Sep2007

2.7Jan2011

2.7.1Jul2012

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The UB2 segment contains data necessary to complete UB92 bills specific to the United States. Realms outside the US are referred to chapter 16. Only Uniform Billing 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. Uniform Billing 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.

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

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