UB2
Uniform Billing Data 2
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
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| C.Len | Element | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| 1 | 1..4 | - | SI | O | 1 | - | 00553 | UB2-1 | Set ID - UB2 |
| 2 | 1..3 | - | ST | O | 1 | - | 00554 | UB2-2 | Co-Insurance Days (9) |
| 3 | - | - | CWE | O | 7 | 0043 | 00555 | UB2-3 | Condition Code (24-30) |
| 4 | 1..3 | - | ST | O | 1 | - | 00556 | UB2-4 | Covered Days (7) |
| 5 | 1..4 | - | ST | O | 1 | - | 00557 | UB2-5 | Non-Covered Days (8) |
| 6 | - | - | UVC | O | 12 | - | 00558 | UB2-6 | Value Amount & Code (39-41) |
| 7 | - | - | OCD | O | 8 | - | 00559 | UB2-7 | Occurrence Code & Date (32-35) |
| 8 | - | - | OSP | O | 2 | - | 00560 | UB2-8 | Occurrence Span Code/Dates (36) |
| 9 | 1..29 | - | ST | O | 2 | - | 00561 | UB2-9 | Uniform Billing Locator 2 (state) |
| 10 | 1..12 | - | ST | O | 2 | - | 00562 | UB2-10 | Uniform Billing Locator 11 (state) |
| 11 | 1..5 | - | ST | O | 1 | - | 00563 | UB2-11 | Uniform Billing Locator 31 (national) |
| 12 | 1..23 | - | ST | O | 3 | - | 00564 | UB2-12 | Document Control Number |
| 13 | 1..4 | - | ST | O | 23 | - | 00565 | UB2-13 | Uniform Billing Locator 49 (national) |
| 14 | 1..14 | - | ST | O | 5 | - | 00566 | UB2-14 | Uniform Billing Locator 56 (state) |
| 15 | 1..27 | - | ST | O | 1 | - | 00567 | UB2-15 | Uniform Billing Locator 57 (sational) |
| 16 | 1..2 | - | ST | O | 2 | - | 00568 | UB2-16 | Uniform Billing Locator 78 (state) |
| 17 | 1..3 | - | NM | O | 1 | - | 00815 | UB2-17 | Special Visit Count |
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