SV2 Institutional Service

To specify the claim service detail for a Health Care institution

Position
Element
Name
Type
Requirement
Min
Max
Repeat
SV2-01
Product/Service ID
String (AN)
Conditional
1
30
-
Identifying number for a product or service.
R0103: At least one of SV2-01 or SV2-03 is required
SV201 is revenue code.
SV2-02
Product/Service ID Qualifier
Identifier (ID)
Conditional
2
2
-
Code identifying the type/source of the descriptive number used in Product/Service ID (234).
P0203: If either SV2-02 or SV2-03 is present, then the other is required
SV2-03
Product/Service ID
String (AN)
Conditional
1
30
-
Identifying number for a product or service.
SV2-04
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
SV204 is submitted charge amount.
SV2-05
Unit or Basis for Measurement Code
Identifier (ID)
Conditional
2
2
-
Code specifying the units in which a value is being expressed, or manner in which a measurement has been taken
P0506: If either SV2-05 or SV2-06 is present, then the other is required
SV2-06
Quantity
Decimal number (R)
Conditional
1
15
-
Numeric value of quantity.
SV2-07
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
SV2-08
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
SV2-09
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
SV2-10
Unit Rate
Decimal number (R)
Optional
1
10
-
The rate per unit of associate revenue for hospital accommodation
SV2-11
Description
String (AN)
Optional
1
80
-
A free-form description to clarify the related data elements and their content.
SV211 is procedure description.
SV2-12
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
SV212 is non-covered charge amount.
SV2-13
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
-
Code indicating a Yes or No condition or response.
SV213 is detail service line indicator. A ``Y'' value indicates a detail service line. An ``N'' value indicates a summary service line.
SV2-14
Nursing Home Residential Status Code
Identifier (ID)
Optional
1
1
-
Code specifying the status of a nursing home resident at the time of service
SV2-15
Level of Care Code
Identifier (ID)
Optional
1
1
-
Code specifying the level of care provided by a nursing home facility

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