New: Drop-in replacement for Change Healthcare APIs

EDI 112 Property Damage Report

Functional Group PQ

X12N Insurance Subcommittee

This X12 Transaction Set contains the format and establishes the data contents of the Property Damage Report Transaction Set (112) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set will be used to provide property damage information between property and casualty insurance companies, independent agents, service and information providers. This information includes, but is not limited to providing cost estimates involving functions such as demolishing, new constructions, damage repair and replacement.

Heading

Position
Segment
Name
Max use
  1. To indicate the start of a transaction set and to assign a control number

  2. To indicate the beginning of a transaction set

  3. To specify any or all of a date, a time, or a time period

  4. To specify the currency being used in the transaction set

  5. 1000 Loop Optional
    Repeat >1
    1. To provide processible supplementary information

    2. To provide a free-form format that allows the transmission of text information

    3. 1100 Loop Mandatory
      Repeat >1
      1. To supply the full name of an individual or organizational entity

        Loop 1100 is used to identify the specific entity related to the Supplementary Information.
      2. To specify additional names

      3. To specify the location of the named party

      4. To specify the geographic place of the named party

      5. To identify a person or office to whom administrative communications should be directed

Detail

Position
Segment
Name
Max use
  1. 2000 Loop Mandatory
    Repeat >1
    1. To identify dependencies among and the content of hierarchically related groups of data segments

      HL01 (Hierarchical ID Number) will be assigned sequentially within the hierarchy starting with one and incremented by one for each HL segment.
      The AD (Administrative Information Level) is mandatory. All other levels are optional.
      The levels BD (Building), UT (Unit or Lot), RM (Room), SR (Subroom), EX (Exception), PS (Property Segment Group), PB (Personal Property), and 9 (Line Item), must always appear (in the transaction set), in the above order, e.g., the Building level cannot be subordinate to the Room level, however the Building level may be omitted.
      V (Name and Address Information) level may be used as a subordinate level to level 9 (Line Item) in order to identify a specific vendor related to the line item.
    2. To transmit identifying information as specified by the Reference Identification Qualifier

    3. To transmit information in a free-form format for comment or special instruction

    4. To specify quantity information

    5. To specify any or all of a date, a time, or a time period

    6. To specify tax information

    7. 2100 Loop Optional
      Repeat >1
      1. To transmit standard code list identification information

        The LM is used in the Line Item Hierarchical Level. The Agency Qualifier Code will identify the Agency whose code list will be used to identify the Product/Service in the SLN.
      2. To specify product subline detail item data

      3. To indicate the total monetary amount

      4. To specify any or all of a date, a time, or a time period

    8. 2200 Loop Optional
      Repeat >1
      1. To report information

      2. To indicate the total monetary amount

      3. To qualify percent amounts and supply percent amounts

    9. 2300 Loop Optional
      Repeat >1
      1. To supply the full name of an individual or organizational entity

      2. To specify additional names

      3. To specify the location of the named party

      4. To specify the geographic place of the named party

      5. To specify the location of a piece of equipment, a shipment, or real property in terms of city and state or longitude and latitude or postal code

      6. To identify a person or office to whom administrative communications should be directed

    10. 2400 Loop Optional
      Repeat >1
      1. To specify the general class or specific characteristic upon which test results are being reported or are to be taken

      2. To specify physical measurements or counts, including dimensions, tolerances, variances, and weights (See Figures Appendix for example of use of C001)

  2. To indicate the end of the transaction set and provide the count of the transmitted segments (including the beginning (ST) and ending (SE) segments)

Stedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference is provided for marketing purposes and is 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.