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Segment
in
X12 Release 003030

SVC Service Information

To supply payment and control information to a provider for a particular service
Sequence
Element
Name
Type
Requirement
Min
Max
Repeat
01
235
Product/Service ID Qualifier
Identifier (ID)
Mandatory
2
2
-
Code identifying the type/source of the descriptive number used in Product/Service ID (234).
For Medicare Part A claims SVC01 would be the Health Care Financing Administration (HCFA) Common Procedural Coding System (HCPCS) Code (see Code Source 130), SVC05 the Revenue Code (see Code Source 132) and SVC06, SVC07, and SVC08 would be HCPCS modifiers (see Code Source 130).
Codes (275)
02
Product/Service ID
String (AN)
Mandatory
1
30
-
Identifying number for a product or service.
03
Monetary Amount
Decimal number (R)
Mandatory
1
15
-
Monetary amount.
SVC03 is the submitted service charge.
04
Monetary Amount
Decimal number (R)
Mandatory
1
15
-
Monetary amount.
SVC04 is the amount paid this service.
05
Product/Service ID
String (AN)
Optional
1
30
-
Identifying number for a product or service.
SVC05 is the National Uniform Billing Committee Revenue Code.
06
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
SVC06 modifies the value in SVC02.
07
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
SVC07 modifies the value in SVC02.
08
Procedure Modifier
String (AN)
Optional
2
2
-
This identifies special circumstances related to the performance of the service, as defined by trading partners
SVC08 modifies the value in SVC02.
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Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference and Mapping Guides are provided for marketing purposes and are free of charge. All names, logos, and brands of third parties listed on our site are trademarks of their respective owners (including “X12”, which is a trademark of X12 Incorporated). Stedi, Inc. and its products and services are not endorsed by, sponsored by, or affiliated with these third parties. Our use of these names, logos, and brands is for identification purposes only, and does not imply any such endorsement, sponsorship, or affiliation.