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.
48
C.LenElementv2.8.1
1--EIR1-01955PSL-1Provider Product/Service Line Item Number
2--EIO1-01956PSL-2Payer Product/Service Line Item Number
31..4-SIR1-01957PSL-3Product/Service Line Item Sequence Number
4--EIO1-01958PSL-4Provider Tracking ID
5--EIO1-01959PSL-5Payer Tracking ID
6--CWER1055901960PSL-6Product/Service Line Item Status
7--CWER1087901961PSL-7Product/Service Code
8--CWEO5088001962PSL-8Product/Service Code Modifier
9-80#STO1-01963PSL-9Product/Service Code DescriptionConf Length
10--DTMC1-01964PSL-10Product/Service Effective Date
11--DTMO1-01965PSL-11Product/Service Expiration Date
12--CQC1056001966PSL-12Product/Service Quantity
13--CPC1-01967PSL-13Product/Service Unit Cost
14-10#NMC1-01968PSL-14Number of Items per UnitConf Length
15--CPC1-01969PSL-15Product/Service Gross Amount
16--CPC1-01970PSL-16Product/Service Billed Amount
17--CWEO20056101971PSL-17Product/Service Clarification Code Type
18-40=STO20-01972PSL-18Product/Service Clarification Code ValueConf Length
19--EIO5-01973PSL-19Health Document Reference Identifier
20--CWEO20056201974PSL-20Processing Consideration Code
211..4-IDR1053201975PSL-21Restricted Disclosure Indicator
22--CWEO1087901976PSL-22Related Product/Service Code Indicator
23--CPO1-01977PSL-23Product/Service Amount for Physician
24-5#NMO1-01978PSL-24Product/Service Cost FactorConf Length
25--CXO1-01933PSL-25Cost Center
26--DRO1-01980PSL-26Billing Period
27-5=NMO1-01981PSL-27Days without BillingConf Length
281..4-NMO1-01982PSL-28Session-No
29--XCNO1-01983PSL-29Executing Physician ID
30--XCNO1-01984PSL-30Responsible Physician ID
31--CWEO1088101985PSL-31Role Executing Physician
32--CWEO1088201986PSL-32Medical Role Executing Physician
33--CWEO1089401987PSL-33Side of body
34-6#NMO1-01988PSL-34Number of TP's PPConf Length
35--CPO1-01989PSL-35TP-Value PP
36-4#NMO1-01990PSL-36Internal Scaling Factor PPConf Length
37-4#NMO1-01991PSL-37External Scaling Factor PPConf Length
38--CPO1-01992PSL-38Amount PP
39-6#NMO1-01993PSL-39Number of TP's Technical PartConf Length
40--CPO1-01994PSL-40TP-Value Technical Part
41-4#NMO1-01995PSL-41Internal Scaling Factor Technical PartConf Length
42-4#NMO1-01996PSL-42External Scaling Factor Technical PartConf Length
43--CPO1-01997PSL-43Amount Technical Part
44--CPO1-01998PSL-44Total Amount Professional Part + Technical Part
45-3=NMO1-01999PSL-45VAT-RateConf Length
461..20-IDO1-02000PSL-46Main-Service
471-IDO1013602001PSL-47Validation
48-255=STO1-02002PSL-48CommentConf Length
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