837I Edit Lookup Tool

The Edit Lookup Tools allow submitters to access rejection information they receive on their TA1, 999 or 277CA reports. The tool provides the user with detailed information as to what the rejection is related to.

To use the Edit Lookup Tool, enter in either part of the rejection code or a keyword.

Example of a rejection from a 277CA report:
STC*A7:500:GB*20240120*U*10384.72~

Using this example, enter either the A7, the 500 or the GB. The 500 would be the best option for narrowing down the specific error.

Enter rejection code or keyword

837I Edit Reference	Description	ID	Min. Max.	Usage Req.	Loop Repeat	5010 Values	TA1/ 999/ 277CA	Disposition/ Error Code	Proposed 5010 Edits
X223 C3 ISA 010	INTERCHANGE CONTROL HEADER	N/A	1	R	1	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	ISA must be present.
X223 C3 ISA 017	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 022: "Invalid Control Structure" -OR- TA105 = 023: "Improper (Premature) End-of-File (Transmission)" -OR- TA105: 024 "Invalid Interchange Content".	Only one iteration of ISA is allowed.
X223 C3 ISA01 010	Authorization Information Qualifier	ID	2-2	R	N/A	00, 03	TA1	TA105 = 010: "Invalid Authorization Information Qualifier Value".	ISA01 must be present.
X223 C3 ISA01 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 010: "Invalid Authorization Information Qualifier Value".	ISA01 must be valid values.
X223 C3 ISA02 010	Authorization Information	AN	10-10	R	N/A	N/A	TA1	TA105 = 011: "Invalid Authorization Information Value".	ISA02 must be present.
X223 C3 ISA02 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 011: "Invalid Authorization Information Value".	ISA02 must be 10 characters.
X223 C3 ISA02 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 011: "Invalid Authorization Information Value".	ISA02 must be populated with accepted AN characters OR ISA02 must be populated with all spaces.
X223 C3 ISA03 010	Security Information Qualifier	ID	2-2	R	N/A	00, 01	TA1	TA105 = 012: "Security Information Qualifier Value".	ISA03 must be present.
X223 C3 ISA03 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 012: "Security Information Qualifier Value".	ISA03 must be valid values.
X223 C3 ISA04 010	Security Information	AN	10-10	R	N/A	N/A	TA1	TA105 = 013: "Security Information Value".	ISA04 must be present.
X223 C3 ISA04 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 013: "Security Information Value".	ISA04 must be 10 characters.
X223 C3 ISA04 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 013: "Security Information Value".	ISA04 must be populated with accepted AN characters OR ISA04 must be populated with all spaces.
X223 C3 ISA05 010	Interchange ID Qualifier	ID	2-2	R	N/A	01, 14, 20, 27, 28, 29, 30, 33, ZZ	TA1	TA105 = 005: "Invalid Interchange ID Qualifier for Sender".	ISA05 must be present.
X223 C3 ISA05 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 005: "Invalid Interchange ID Qualifier for Sender".	ISA05 must be "27", "28" or "ZZ".
X223 C3 ISA06 010	Interchange Sender ID	AN	15-15	R	N/A	N/A	TA1	TA105 = 006: "Invalid Interchange Sender ID".	ISA06 must be present.
X223 C3 ISA06 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 006: "Invalid Interchange Sender ID".	ISA06 must be 15 characters.
X223 C3 ISA06 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 006: "Invalid Interchange Sender ID".	ISA06 must contain at least one non-space character.
X223 C3 ISA06 040	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 006: "Invalid Interchange Sender ID".	ISA06 must be populated with accepted AN characters.
X223 C3 ISA07 010	Interchange ID Qualifier	ID	2-2	R	N/A	01, 14, 20, 27, 28, 29, 30, 33, ZZ	TA1	TA105 = 007: "Invalid Interchange ID Qualifier for Receiver".	ISA07 must be present.
X223 C3 ISA07 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 007: "Invalid Interchange ID Qualifier for Receiver".	ISA07 must be "27", "28" or "ZZ".
X223 C3 ISA08 010	Interchange Receiver ID	AN	15-15	R	N/A	N/A	TA1	TA105 = 008: "Invalid Interchange Receiver ID".	ISA08 must be present.
X223 C3 ISA08 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 008: "Invalid Interchange Receiver ID".	ISA08 must be 15 characters.
X223 C3 ISA08 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 008: "Invalid Interchange Receiver ID".	ISA08 must contain at least one non-space character.
X223 C3 ISA08 040	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 008: "Invalid Interchange Receiver ID".	ISA08 must be populated with accepted AN characters.
X223 C3 ISA09 010	Interchange Date	DT	6-6	R	N/A	N/A	TA1	TA105 = 014: "Invalid Interchange Date Value".	ISA09 must be present.
X223 C3 ISA09 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 014: "Invalid Interchange Date Value".	ISA09 must be a valid date in YYMMDD format.
X223 C3 ISA09 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 014: "Invalid Interchange Date Value".	ISA09 must be a the date of the interchange; must not be a future date.
X223 C3 ISA10 010	Interchange Time	TM	4-4	R	N/A	HHMM	TA1	TA105 = 015: "Invalid Interchange Time Value".	ISA10 must be present.
X223 C3 ISA10 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 015: "Invalid Interchange Time Value".	ISA10 must be a valid time in HHMM format.
X223 C3 ISA11 010	Repetition Separator	N/A	1-1	R	N/A	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	ISA11 must be present.
X223 C3 ISA11 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	ISA11 must be 1 character.
X223 C3 ISA11 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	ISA11 must contain at least one non-space character.
X223 C3 ISA12 010	Interchange Control Version Number	ID	5-5	R	N/A	00501	TA1	TA105 = 017: "Invalid Interchange Version ID Value".	ISA12 must be present.
X223 C3 ISA12 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 017: "Invalid Interchange Version ID Value".	ISA12 must be "00501".
X223 C3 ISA13 010	Interchange Control Number	N0	9-9	R	N/A	N/A	TA1	TA105 = 018: "Invalid Interchange Control Number Value".	ISA13 must be present.
X223 C3 ISA13 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 018: "Invalid Interchange Control Number Value".	ISA13 must be numeric.
X223 C3 ISA13 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 018: "Invalid Interchange Control Number Value".	ISA13 must be 9 characters.
X223 C3 ISA13 040	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 018: "Invalid Interchange Control Number Value".	ISA13 must be > 0.
X223 C3 ISA13 050	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 018: "Invalid Interchange Control Number Value".	ISA13 must be unsigned.
X223 C3 ISA14 010	Acknowledgement Requested	ID	1-1	R	N/A	0, 1	TA1	TA105 = 019: "Invalid Acknowledgment Requested Value".	ISA14 must be present.
X223 C3 ISA14 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 019: "Invalid Acknowledgment Requested Value".	ISA14 must be valid values.
X223 C3 ISA15 010	Usage Indicator	ID	1-1	R	N/A	P, T	TA1	TA105 = 020: "Invalid Test Indicator Value".	ISA15 must be present.
X223 C3 ISA15 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 020: "Invalid Test Indicator Value".	ISA15 must be valid values.
X223 C3 ISA16 010	Component Element Separator	N/A	1-1	R	N/A	N/A	TA1	TA105 = 027: "Invalid Component Element Separator"	ISA16 must be present.
X223 C3 ISA16 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 027: "Invalid Component Element Separator"	ISA16 must be 1 character
X223 C3 ISA16 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 027: "Invalid Component Element Separator"	ISA16 must contain at least one non-space character.
X223 C7 GS 010	FUNCTIONAL GROUP HEADER	N/A	1	R	1	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	GS must be present.
X223 C7 GS 020	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 1 "Functional Group Not Supported".	Only one iteration of GS is allowed.
X223 C7 GS01 010	Functional Identifier Code	ID	2-2	R	N/A	HC	999	AK905: 1 "Functional Group Not Supported".	GS01 must be present.
X223 C7 GS01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 1 "Functional Group Not Supported".	GS01 must be "HC".
X223 C7 GS02 010	Application Sender Code	AN	2-15	R	N/A	N/A	999	AK905: 14 "Unknown Security Originator".	GS02 must be present.
X223 C7 GS02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 14 "Unknown Security Originator".	GS02 must be 2-15 characters.
X223 C7 GS02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 14 "Unknown Security Originator".	GS02 must contain at least two non-space characters.
X223 C7 GS02 040	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 14 "Unknown Security Originator".	GS02 must be populated with accepted AN characters.
X223 C7 GS03 010	Application Receiver Code	AN	2-15	R	N/A	N/A	999	AK905: 13 "Unknown Security Recipient".	GS03 must be present.
X223 C7 GS03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 13 "Unknown Security Recipient".	GS03 must be 2-15 characters.
X223 C7 GS03 030	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 13 "Unknown Security Recipient".	GS03 must contain at least two non-space characters.
X223 C7 GS03 040	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 13 "Unknown Security Recipient".	GS03 must be populated with accepted AN characters.
X223 C7 GS04 010	Date	DT	8-8	R	N/A	CCYYMMDD	TA1	TA105 = 024: "Invalid Interchange Content".	GS04 must be present.
X223 C7 GS04 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	GS04 must be a valid date in CCYYMMDD format.
X223 C7 GS04 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	GS04 must be the date the functional group is created; must not be a future date.
X223 C7 GS05 010	Time	TM	4-8	R	N/A	HHMM, HHMMSS, HHMMSSD, HHMMSSDD	TA1	TA105 = 024: "Invalid Interchange Content".	GS05 must be present.
X223 C7 GS05 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	GS05 must be a valid time in a valid format.
X223 C7 GS06 010	Group Control Number	N0	1-9	R	N/A	N/A	999	AK905: 6 "Group Control Number Violates Syntax".	GS06 must be present.
X223 C7 GS06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 6 "Group Control Number Violates Syntax".	GS06 must be numeric.
X223 C7 GS06 030	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 6 "Group Control Number Violates Syntax".	GS06 must be > 0.
X223 C7 GS06 040	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 6 "Group Control Number Violates Syntax".	GS06 must be < =999,999,999.
X223 C7 GS06 050	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 19 "Functional Group Control Number not Unique within Interchange.	GS06 must be unique within the interchange.
X223 C7 GS07 010	Responsible Agency Code	ID	1-2	R	N/A	X	TA1	TA105 = 024: "Invalid Interchange Content".	GS07 must be present.
X223 C7 GS07 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 024: "Invalid Interchange Content".	GS07 must be "X".
X223A2 41 GS08 010	Version Identifier Code	AN	1-12	R	N/A	005010X223A2	999	AK905: 2 "Functional Group Version Not Supported"	GS08 must be present.
X223A2 41 GS08 020	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 2 "Functional Group Version Not Supported"	GS08 must be "005010X223A2".
X223 067 ST 010	TRANSACTION SET HEADER	N/A	1	R	>1	N/A	999	IK502 = 6: "Missing or Invalid Transaction Set Identifier".	ST must be present.
X223 067 ST 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 1: "Transaction Set Not Supported" OR AK905 = 5: "Number Included Transaction Sets Does Not Match Actual Count" OR IK502 = 6: "Missing or Invalid Transaction Set Identifier" OR IK502 = I5: "Implementation One or More Segments in Error"	Only one iteration of ST is allowed.
X223 067 ST01 010	Transaction Set Identifier Code	ID	3-3	R	N/A	837	999	IK502 = 6: "Missing or Invalid Transaction Set Identifier".	ST01 must be present.
X223 067 ST01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 6: "Missing or Invalid Transaction Set Identifier".	ST01 must be "837".
X223 067 ST02 010	Transaction Set Control Number	AN	4-9	R	N/A	N/A	999	IK502 = 7: "Missing or Invalid Transaction Set Control Number".	ST02 must be present.
X223 067 ST02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 7: "Missing or Invalid Transaction Set Control Number".	ST02 must be 4-9 characters.
X223 067 ST02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 7: "Missing or Invalid Transaction Set Control Number".	ST02 must contain at least four non-space characters.
X223 067 ST02 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 7: "Missing or Invalid Transaction Set Control Number".	ST02 must be populated with accepted AN characters.
X223 067 ST02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 23: "Transaction Set Control Number Not Unique within the Functional Group".	ST02 must be a unique number within the functional group.
X223A2 14 ST03 010	Version, Release, or Industry Identifier	AN	1-35	R	N/A	005010X223A2	999	IK502 = I6: "Implementation Convention Not Supported".	ST03 must be present.
X223A2 14 ST03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 19: "Invalid Transaction Set Implementation Convention reference".	ST03 must be "005010X223A2".
X223 068 BHT 010	BEGINNING OF HIERARCHICAL TRANSACTION	N/A	1	R	1	N/A	999	IK304 = 3: "Required Segment Missing"	BHT must be present.
X223 068 BHT 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only iteration of BHT is allowed.
X223 068 BHT01 010	Hierarchical Structure Code	ID	4-4	R	N/A	0019	999	IK403 = 1: "Required Data Element Missing"	BHT01 must be present.
X223 068 BHT01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	BHT01 must be "019".
X223 068 BHT02 010	Transaction Set Purpose Code	ID	2-2	R	N/A	00, 18	999	IK403 = 1: "Required Data Element Missing"	BHT02 must be present.
X223 068 BHT02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	BHT02 must be valid values.
X223 068 BHT03 010	Originator Application Transaction ID	AN	1-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	BHT03 must be present.
X223 068 BHT03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	BHT03 must be 1-30 characters.
X223 068 BHT03 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	BHT03 must be populated with accepted AN characters.
X223 068 BHT04 010	Transaction Set Creation Date	DT	8-8	R	N/A	CCYYMMDD	999	IK403 = 1: "Required Data Element Missing"	BHT04 must be present.
X223 068 BHT04 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	BHT04 must be a valid date in CCYYMMDD format.
X223 068 BHT05 010	Transaction Set Creation Time	TM	4-8	R	N/A	HHMM, HHMMSS, HHMMSSD, HHMMSSDD	999	IK403 = 1: "Required Data Element Missing"	BHT05 must be present.
X223 068 BHT05 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 9: "Invalid Time"	BHT05 must be a valid time in a valid time format.
X223 068 BHT06 010	Claim or Encounter ID	ID	2-2	R	N/A	31, CH, RP	999	IK403 = 1: "Required Data Element Missing"	BHT06 must be present.
X223 068 BHT06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	BHT06 must be "CH".
X223 071 1000A 010	SUBMITTER NAME LOOP	N/A	1	R	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 1000A is allowed.
X223 071 1000A NM1 010	SUBMITTER NAME	N/A	N/A	N/A	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	1000A.NM1 must be present.
X223 071 1000A NM101 010	Entity Identifier Code	ID	2-3	R	N/A	41	999	IK403 = 1: "Required Data Element Missing"	1000A.NM101 must be present.
X223 071 1000A NM101 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000A.NM101 must be "41".
X223 071 1000A NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1, 2	999	IK403 = 1: "Required Data Element Missing"	1000A.NM102 must be present.
X223 071 1000A NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000A.NM102 must be valid values.
X223 071 1000A NM103 010	Submitter Last or Organization Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	1000A.NM103 must be present.
X223 071 1000A NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.NM103 must contain at least one non-space character.
X223 071 1000A NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.NM103 must be populated with accepted AN characters.
X223 071 1000A NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	1000A.NM103 must be 1 - 60 characters.
X223 071 1000A NM104 010	Submitter First Name	AN	1-35	S	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	If 1000A.NM102 is "2", 1000A.NM104 must not be present.
X223 071 1000A NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	1000A.NM104 must be 1 - 35 characters.
X223 071 1000A NM104 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.NM104 must contain at least one non-space character.
X223 071 1000A NM104 060	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.NM104 must be populated with accepted AN characters.
X223 071 1000A NM105 010	Submitter Middle Name	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.NM105 must contain at least one non-space character.
X223 071 1000A NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	If 1000A.NM102 is "2", 1000A.NM105 must not be present.
X223 071 1000A NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	1000A.NM105 must be 1 - 25 characters.
X223 071 1000A NM105 060	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.NM105 must be populated with accepted AN characters.
X223 071 1000A NM105 065	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: 41 "Submitter"	The first position of 1000A.NM105 must be alphabetic (A...Z).
X223 071 1000A NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 071 1000A NM107 010	Name Suffix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 071 1000A NM108 010	Identification Code Qualifier	ID	1-2	R	N/A	46	999	IK403 = 1: "Required Data Element Missing"	1000A.NM108 must be present.
X223 071 1000A NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000A.NM108 must be "46".
X223 071 1000A NM109 010	Submitter Identifier	AN	2-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	1000A.NM109 must be present.
X223 071 1000A NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.NM109 must contain at least two non-space characters.
X223 071 1000A NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	1000A.NM109 must be 2-80 characters.
X223 071 1000A NM109 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.NM109 must be populated with accepted AN characters.
X223 071 1000A NM109 070	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	1000A.NM109 must be an approved electronic submitter.
X223 071 1000A NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 071 1000A NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 071 1000A NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 073 1000A PER 010	SUBMITTER EDI CONTACT INFORMATION	N/A	2	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	1000A.PER must be present.
X223 073 1000A PER 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 1000A.PER are allowed.
X223 073 1000A PER01 010	Contact Function Code	ID	2-2	R	N/A	IC	999	IK403 = 1: "Required Data Element Missing"	1000A.PER01 must be present.
X223 073 1000A PER01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000A.PER01 must be "IC".
X223 073 1000A PER02 010	Submitter Contact Name	AN	1-60	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.PER02 must contain at least one non-space character.
X223 073 1000A PER02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	For the 1st 1000A.PER transmitted, 1000A.PER02 must not = 1000A.NM103.
X223 073 1000A PER02 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	For the 2nd 1000A.PER transmitted, 1000A.PER02 must not be present.
X223 073 1000A PER02 060	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	1000A.PER02 must be 1 - 60 characters.
X223 073 1000A PER02 080	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.PER02 must be populated with accepted AN characters.
X223 073 1000A PER03 010	Communication Number Qualifier	ID	2-2	R	N/A	EM, FX. TE	999	IK403 = 1: "Required Data Element Missing"	1000A.PER03 must be present.
X223 073 1000A PER03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000A.PER03 must be valid values.
X223 073 1000A PER04 010	Communication Number	AN	1-256	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	1000A.PER04 must be present.
X223 073 1000A PER04 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.PER04 must contain at least one non-space character.
X223 073 1000A PER04 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	1000A.PER04 must be 1 - 256 characters.
X223 073 1000A PER04 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.PER04 must be populated with accepted AN characters.
X223 073 1000A PER04 070	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 127: "Entity's Communication Number" EIC: 41 "Submitter"	1000A.PER04 must be populated with exactly ten numeric characters when 1000A.PER03 equals TE or FX.
X223 073 1000A PER05 010	Communication Number Qualifier	ID	2-2	S	N/A	EM, EX, FX, TE	999	IK403 = 7: "Invalid Code Value"	1000A.PER05 must be valid values.
X223 073 1000A PER05 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	If 1000A.PER05 is "EX", 1000A.PER03 must be "TE".
X223 073 1000A PER06 010	Communication Number	AN	1-256	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 1000A.PER06 is present, 1000A.PER05 must be present.
X223 073 1000A PER06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.PER06 must contain at least one non-space character.
X223 073 1000A PER06 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	1000A.PER06 must be 1 - 256 characters.
X223 073 1000A PER06 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.PER06 must be populated with accepted AN characters.
X223 073 1000A PER06 070	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 127: "Entity's Communication Number" EIC: 41 "Submitter"	1000A.PER06 must be populated with exactly ten numeric characters when 1000A.PER05 equals TE or FX.
X223 073 1000A PER07 010	Communication Number Qualifier	ID	2-2	S	N/A	EM, EX, FX, TE	999	IK403 = 2: "Conditional Required Data Element Missing"	If 1000A.PER07 is present, 1000A.PER05 must be present.
X223 073 1000A PER07 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000A.PER07 must be valid values.
X223 073 1000A PER07 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	If 1000A.PER07 is "EX", 1000A.PER05 must be "TE".
X223 073 1000A PER08 010	Communication Number	AN	1-256	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 1000A.PER08 is present, 1000A.PER07 must be present.
X223 073 1000A PER08 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.PER08 must contain at least one non-space character.
X223 073 1000A PER08 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	1000A.PER08 must be 1 - 256 characters.
X223 073 1000A PER08 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000A.PER08 must be populated with accepted AN characters.
X223 073 1000A PER08 070	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 127: "Entity's Communication Number" EIC: 41 "Submitter"	1000A.PER08 must be populated with exactly ten numeric characters when 1000A.PER07 equals TE or FX.
X223 073 1000A PER09 010	Contact Inquiry Reference	AN	1-20	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 076 1000B 010	RECEIVER NAME LOOP	N/A	1	R	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 1000B is allowed.
X223 076 1000B NM1 010	RECEIVER NAME	N/A	N/A	N/A	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	1000B.NM1 must be present.
X223 076 1000B NM101 010	Entity Identifier Code	ID	2-3	R	N/A	40	999	IK403 = 1: "Required Data Element Missing"	1000B.NM101 must be present.
X223 076 1000B NM101 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000B.NM101 must be "40".
X223 076 1000B NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	2	999	IK403 = 1: "Required Data Element Missing"	1000B.NM102 must be present.
X223 076 1000B NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000B.NM102 must be "2".
X223 076 1000B NM103 010	Receiver Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	1000B.NM103 must be present.
X223 076 1000B NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	1000B.NM103 must be 1-60 characters.
X223 076 1000B NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000B.NM103 must be populated with accepted AN characters.
X223 076 1000B NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	1000B.NM103 must contain at least one non-space character.
X223 076 1000B NM104 010	Name First	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 076 1000B NM105 010	Name Middle	AN	1-25	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 076 1000B NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 076 1000B NM107 010	Name Suffix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 076 1000B NM108 010	Identification Code Qualifier	ID	1-2	R	N/A	46	999	IK403 = 1: "Required Data Element Missing"	1000B.NM108 must be present.
X223 076 1000B NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	1000B.NM108 must be "46".
X223 076 1000B NM109 010	Receiver Primary Identifier	AN	2-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	1000B.NM109 must be present.
X223 076 1000B NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	1000B.NM109 must be [contractor put receiver code here].
X223 076 1000B NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	1000B NM109 must equal GS03
X223 076 1000B NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 076 1000B NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 076 1000B NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 078 2000A HL 010	BILLING/PAY-TO PROVIDER HIERARCHICAL LEVEL	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2000A.HL must be present.
X223 078 2000A HL 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2000A.HL is allowed.
X223 078 2000A HL01 010	Hierarchical ID Number	AN	1-12	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2000A.HL01 must be present.
X223 078 2000A HL01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2000A.HL01 must be 1-12 characters.
X223 078 2000A HL01 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2000A.HL01 must be numeric value.
X223 078 2000A HL01 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	The first HL01 must be "1".
X223 078 2000A HL02 010	Hierarchical Parent ID Number	AN	1-12	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 078 2000A HL03 010	Hierarchical Level Code	ID	1-2	R	N/A	20	999	IK403 = 1: "Required Data Element Missing"	2000A.HL03 must be present.
X223 078 2000A HL03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2000A.HL03 must be "20".
X223 078 2000A HL04 010	Hierarchical Child Code	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2000A.HL04 must be present.
X223 078 2000A HL04 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2000A.HL04 must be "1".
X223 080 2000A PRV 010	BILLING/PAY-TO PROVIDER SPECIALTY INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2000A.PRV is allowed.
X223 080 2000A PRV01 010	Provider Code	ID	1-3	R	N/A	BI	999	IK403 = 1: "Required Data Element Missing"	2000A PRV01 must be present.
X223 080 2000A PRV01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2000A.PRV01 must be "BI".
X223 080 2000A PRV02 010	Reference Identification Qualifier	ID	2-3	R	N/A	PXC	999	IK403 = 1: "Required Data Element Missing"	2000A.PRV02 must be present.
X223 080 2000A PRV02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2000A.PRV02 must be "PXC".
X223 080 2000A PRV03 010	Provider Taxonomy Code	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2000A.PRV03 must be present.
X223 080 2000A PRV03 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 145: "Entity's specialty/taxonomy code" EIC: 85 Billing Provider	2000A.PRV03 Must be a valid Provider Taxonomy Code.
X223 080 2000A PRV04 010	State or Province Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 080 2000A PRV05 010	PROVIDER SPECIALTY INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 080 2000A PRV06 010	Provider Organization Code	ID	3-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 081 2000A CUR 010	FOREIGN CURRENCY INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = I4: "Implementation "Not Used" Segment Present"	2000A.CUR must not be present.
X223 081 2000A CUR 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 681: "Claim Currency Not Supported"	N/A
X223 084 2010AA 010	Billing Provider Name Loop	N/A	1	R	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2010AA is allowed.
X223 084 2010AA NM1 010	Billing Provider Name	N/A	N/A	N/A	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2010AA.NM1 must be present.
X223 084 2010AA NM101 010	Entity Identifier Code	ID	2-3	R	N/A	85	999	IK403 = 1: "Required Data Element Missing"	2010AA.NM101 must be present.
X223 084 2010AA NM101 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AA.NM101 must be "85".
X223 084 2010AA NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	2	999	IK403 = 1: "Required Data Element Missing"	2010AA.NM102 must be present.
X223 084 2010AA NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AA.NM102 must be "2".
X223 084 2010AA NM103 010	Billing Provider Last or Organizational Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010AA.NM103 must be present.
X223 084 2010AA NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.NM103 must contain at least one non-space character.
X223 084 2010AA NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AA.NM103 must be 1-60 characters.
X223 084 2010AA NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: 85 "Billing Provider"	N/A
X223 084 2010AA NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.NM103 must be populated with accepted AN characters.
X223 084 2010AA NM104 010	Name First	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 084 2010AA NM105 010	Name Middle	AN	1-25	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 084 2010AA NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 084 2010AA NM107 010	Name Suffix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 084 2010AA NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 85 "Billing Provider"	2010AA.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 084 2010AA NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 85 "Billing Provider"	2010AA.NM108 must be present.
X223 084 2010AA NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AA.NM108 must be "XX".
X223 084 2010AA NM109 010	Billing Provider Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010AA.NM108 is present, 2010AA.NM109 must be present.
X223 084 2010AA NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 85 "Billing Provider"	2010AA.NM109 must be valid according to the NPI algorithm.
X223 084 2010AA NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 85 "Billing Provider"	The first position of 2010AA.NM109 must be a "1".
X223 084 2010AA NM109 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 496 "Submitter not approved for electronic claim submissions on behalf of this entity." EIC: 85 "Billing Provider"	2010AA.NM109 billing provider must be "associated" to the submitter (from a trading partner management perspective) in 1000A.NM109.
X223 084 2010AA NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 084 2010AA NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 084 2010AA NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 087 2010AA N3 010	BILLING PROVIDER ADDRESS	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2010AA.N3 must be present.
X223 087 2010AA N3 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010AA.N3 is allowed.
X223 087 2010AA N301 010	Billing Provider Address Line	AN	1-55	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010AA.N301 must be present.
X223 087 2010AA N301 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.N301 must contain at least one non-space character.
X223 087 2010AA N301 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AA.N301 must be 1-55 characters.
X223 087 2010AA N301 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 126: "Entity's Address" EIC: 85 "Billing Provider"	N/A
X223 087 2010AA N301 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.N301 must be populated with accepted AN characters.
X223 087 2010AA N301 070	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 503: "Entity's Street Address" EIC: 85 "Billing Provider"	2010AA.N301 must not contain the following exact phrases (not case sensitive): "Post Office Box", "P.O. BOX", "PO BOX", "LOCK BOX", "LOCK BIN", "P O BOX".
X223 087 2010AA N302 012	Billing Provider Address Line	AN	1-55	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If present, 2010AA.N302 must contain at least one non-space character.
X223 087 2010AA N302 015	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AA.N302 must be 1-55 characters.
X223 087 2010AA N302 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 126: "Entity's Address" EIC: 85 "Billing Provider"	N/A
X223 087 2010AA N302 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.N302 must be populated with accepted AN characters.
X223 088 2010AA N4 010	BILLING PROVIDER CITY/STATE/ZIP CODE	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2010AA.N4 must be present.
X223 088 2010AA N4 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010AA.N4 is allowed.
X223 088 2010AA N401 010	Billing Provider City Name	AN	2-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010AA.N401 must be present.
X223 088 2010AA N401 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.N401 must contain at least two non-space characters.
X223 088 2010AA N401 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2010AA.N401 must be 2-30 characters.
X223 088 2010AA N401 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 502: "Entity's City" EIC: 85 "Billing Provider"	N/A
X223 088 2010AA N401 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.N401 must be populated with accepted AN characters.
X223 088 2010AA N402 010	Billing Provider State or Province Code	ID	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010AA.N404 is not present, 2010AA.N402 must be present.
X223 088 2010AA N402 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 501: "Entity's State/Province" EIC: 85 "Billing Provider"	2010AA.N402 must be a valid state code.
X223 088 2010AA N403 010	Billing Provider Postal Zone or ZIP Code	ID	3-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010AA.N404 is not present, 2010AA.N403 must be present.
X223 088 2010AA N403 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 500: "Entity's Postal/Zip Code" EIC: 85 "Billing Provider"	2010AA.N403 must be a valid 9 digit zip code.
X223 088 2010AA N404 010	Country Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 088 2010AA N405 010	Location Qualifier	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 088 2010AA N406 010	Location Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 088 2010AA N407 010	Country Subdivision Code	ID	1-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 090 2010AA REF 010	BILLING PROVIDER TAX IDENTIFICATION	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2010AA.REF must be present.
X223 090 2010AA REF 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010AA.REF with REF01 = "EI" is allowed.
X223 090 2010AA REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	EI	999	IK403 = 1: "Required Data Element Missing"	2010AA.REF01 must be present.
X223 090 2010AA REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AA.REF01 must be "EI".
X223 090 2010AA REF02 010	Billing Provider Additional Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010AA.REF02 must be present.
X223 090 2010AA REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.REF02 must be populated with accepted AN characters.
X223 090 2010AA REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 128: "Entity's tax id" EIC: 85 "Billing Provider"	2010AA.REF02 must be 9 digits with no punctuation.
X223 090 2010AA REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 562: "Entity's National Provider Identifier (NPI)" CSC 128: "Entity's tax id" EIC: 85 "Billing Provider"	2010AA.REF must be associated with the provider identified in 2010AA.NM109
X223 090 2010AA REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 090 2010AA REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 091 2010AA PER 020	BILLING PROVIDER CONTACT INFORMATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2010AA.PER are allowed.
X223 091 2010AA PER01 010	Contact Function Code	ID	2-2	R	N/A	IC	999	IK403 = 1: "Required Data Element Missing"	2010AA.PER01 must be present.
X223 091 2010AA PER01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AA.PER01 must be "IC".
X223 091 2010AA PER02 010	Billing Provider Contact Name	AN	1-60	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	For the 1st 2010AA.PER transmitted, 2010AA.PER02 must be present.
X223 091 2010AA PER02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	For the 2nd 2010AA.PER transmitted, 2010AA.PER02 must not be present.
X223 091 2010AA PER02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 10: "Exclusion Condition Violated"	2010AA.PER02 must not = 1000A.PER02.
X223 091 2010AA PER02 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.PER02 must contain at least one non-space character.
X223 091 2010AA PER02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AA.PER02 must be 1-60 characters.
X223 091 2010AA PER02 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 561: "Entity's Contact Name" EIC: 85 "Billing Provider"	N/A
X223 091 2010AA PER02 070	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.PER02 must be populated with accepted AN characters.
X223 091 2010AA PER03 010	Communication Number Qualifier	ID	2-2	R	N/A	EM, FX, TE	999	IK403 = 1: "Required Data Element Missing"	2010AA.PER03 must be present.
X223 091 2010AA PER03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AA.PER03 must be valid values.
X223 091 2010AA PER04 010	Communication Number	AN	1-256	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010AA.PER04 must be present.
X223 091 2010AA PER04 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.PER04 must contain at least one non-space character.
X223 091 2010AA PER04 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AA.PER04 must be 1-256 characters.
X223 091 2010AA PER04 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 127: "Entity's Communication Number" EIC: 85 "Billing Provider"	N/A
X223 091 2010AA PER04 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.PER04 must be populated with accepted AN characters.
X223 091 2010AA PER04 070	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 127: "Entity's Communication Number" EIC: 85 "Billing Provider"	2010AA.PER04 must be populated with exactly ten numeric characters when 2010AA.PER03 equals TE or FX.
X223 091 2010AA PER05 010	Communication Number Qualifier	ID	2-2	S	N/A	EM, EX, FX, TE	999	IK403 = 7: "Invalid Code Value"	2010AA.PER05 must be valid values.
X223 091 2010AA PER05 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	If 2010AA.PER05 is "EX" 2010AA.PER03 must be "TE".
X223 091 2010AA PER06 010	Communication Number	AN	1-256	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010AA.PER05 is present 2010AA.PER06 must be present.
X223 091 2010AA PER06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.PER06 must contain at least one non-space character.
X223 091 2010AA PER06 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AA.PER06 must be 1-256 characters.
X223 091 2010AA PER06 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 127: "Entity's Communication Number" EIC: 85 "Billing Provider"	N/A
X223 091 2010AA PER06 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.PER06 must be populated with accepted AN characters.
X223 091 2010AA PER06 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 127: "Entity's Communication Number" EIC: 85 "Billing Provider"	2010AA.PER06 must be populated with exactly ten numeric characters when 2010AA.PER05 equals TE or FX.
X223 091 2010AA PER07 010	Communication Number Qualifier	ID	2-2	S	N/A	EM, EX, FX, TE	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010AA.PER07 is present, 2010AA.PER05 must be present.
X223 091 2010AA PER07 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AA.PER07 must be valid values.
X223 091 2010AA PER07 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	If 2010AA.PER07 is "EX", 2010AA.PER05 must be "TE".
X223 091 2010AA PER08 010	Communication Number	AN	1-256	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010AA.PER07 is present, 2010AA.PER08 must be present.
X223 091 2010AA PER08 015	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.PER08 must contain at least one non-space character.
X223 091 2010AA PER08 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AA.PER08 must be 1-256 characters.
X223 091 2010AA PER08 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 127: "Entity's communication Number" EIC: 85 "Billing Provider"	N/A
X223 091 2010AA PER08 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AA.PER08 must be populated with accepted AN characters.
X223 091 2010AA PER08 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 127: "Entity's Communication Number" EIC: 85 "Billing Provider"	2010AA.PER08 must be populated with exactly ten numeric characters when 2010AA.PER07 equals TE or FX.
X223 091 2010AA PER09 010	Contact Inquiry Reference	AN	1-20	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM1 010	PAY TO ADDRESS NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	One iteration of 2010AB.NM1 is allowed.
X223 094 2010AB NM101 010	Entity Identifier Code	ID	2-3	R	N/A	87	999	IK403 = 1: "Required Data Element Missing"	2010AB.NM101 must be preset.
X223 094 2010AB NM101 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AB.NM101 must be "87".
X223 094 2010AB NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	2	999	IK403 = 1: "Required Data Element Missing"	2010AB.NM102 must be present.
X223 094 2010AB NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010AB.NM102 must be "2".
X223 094 2010AB NM103 010	Pay-to Provider Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM104 010	Name First	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM105 010	Name Middle	AN	1-25	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM107 010	Name Suffix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM108 010	Identification Code Qualifier	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM109 010	Pay-to Provider Identifier	AN	2-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 094 2010AB NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 096 2010AB N3 010	PAY-TO ADDRESS	N/A	1	R	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2010AB.NM1 is present, 2010AB.N3 must be present.
X223 096 2010AB N3 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010AB.N3 is allowed.
X223 096 2010AB N301 010	Pay-to Address Line	AN	1-55	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010AB.N301 must be present.
X223 096 2010AB N301 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AB.N301 must be at least one non-space character.
X223 096 2010AB N301 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AB.N301 must be 1-55 characters.
X223 096 2010AB N301 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 126: "Entity's Address" EIC: 87 "Pay-to Provider"	N/A
X223 096 2010AB N301 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AB.N301 must be populated with accepted AN characters.
X223 096 2010AB N302 020	Pay-to Provider Address Line	AN	1-55	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If present, 2010AB.N302 must be at least one non-space character.
X223 096 2010AB N302 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010AB.N302 must be 1-55 characters.
X223 096 2010AB N302 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 126: "Entity's Address" EIC: 87 "Pay-to Provider"	N/A
X223 096 2010AB N302 060	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AB.N302 must be populated with accepted AN characters.
X223 097 2010AB N4 010	PAY-TO ADDRESS CITY/STATE/ZIP CODE	N/A	1	R	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2010AB.NM1 is present, 2010AB.N4 must be present.
X223 097 2010AB N4 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010AB.N4 is allowed.
X223 097 2010AB N401 010	Pay-to Address City Name	AN	2-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010AB.N401 must be present.
X223 097 2010AB N401 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AB.N401 must contain at least two non-space characters.
X223 097 2010AB N401 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2010AB.N401 must be 2-30 characters.
X223 097 2010AB N401 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 502: "Entity's City" EIC: 87 "Pay-to Provider"	N/A
X223 097 2010AB N401 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010AB.N401 must be populated with accepted AN characters.
X223 097 2010AB N402 010	Pay-to-Address State Code	ID	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010AB.N404 is not present, 2010AB.N402 must be present.
X223 097 2010AB N402 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 501: "Entity's State/Province" EIC: 87 "Pay-to Provider"	2010AB.N402 must be a valid state code.
X223 097 2010AB N403 010	Pay-to Address Postal Zone or ZIP Code	ID	3-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010AB.N404 is not present, 2010AB.N403 must be present.
X223 097 2010AB N403 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 500: "Entity's Postal/Zip Code" EIC: 87 "Pay-to Provider"	2010AB.N403 must be a valid zip code.
X223 097 2010AB N404 010	Country Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 097 2010AB N405 010	Location Qualifier	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 097 2010AB N406 010	Location Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 097 2010AB N407 010	Country Subdivision Code	ID	1-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 099 2010AC NM1 020	PAY-TO PLAN NAME	N/A	1	S	N/A	N/A	277	CSCC A3: "Acknowledgement /Returned as unprocessable claim" CSC 732: "Information submitted inconsistent with billing guidelines." CSC 125: "Entity's name." EIC 87: "Pay-to Provider"	2010AC.NM1 must not be present
X223 101 2010AC N3 010	PAY-TO PLAN ADDRESS	N/A	1	R	N/A	N/A	277	CSCC A3: "Acknowledgement /Returned as unprocessable claim" CSC 732: "Information submitted inconsistent with billing guidelines." CSC 503: "Entity's Street Address." EIC 87: "Pay-to Provider"	2010AC.N3 must not be present.
X223 102 2010AC N4 010	PAY-TO PLAN CITY/STATE/ZIP CODE	N/A	1	R	N/A	N/A	277	CSCC A3: "Acknowledgement /Returned as unprocessable claim" CSC 732: "Information submitted inconsistent with billing guidelines." CSC 126: "Entity's Address." EIC 87: "Pay-to Provider"	2010AC.N4 must not be present.
X223 104 2010AC REF 010	PAY-TO PLAN SECONDARY IDENTIFICATION	N/A	1	S	N/A	N/A	277	CSCC A3: "Acknowledgement /Returned as unprocessable claim" CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier. " EIC 87: "Pay-to Provider"	2010AC.REF with REF01 = 2U, FY, or NF must not be present.
X223 106 2010AC REF 020	PAY-TO PLAN TAX IDENTIFICATION	N/A	1	R	N/A	N/A	277	CSCC A3: "Acknowledgement /Returned as unprocessable claim" CSC 732: "Information submitted inconsistent with billing guidelines." CSC 128: "Entity's tax id." EIC 87: "Pay-to Provider"	2010AC.REF with REF01 = EI must not be present.
X223 107 2000B HL 010	SUBSCRIBER HIERARCHICAL LEVEL	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2000B.HL must be present.
X223 107 2000B HL 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2000B.HL is allowed.
X223 107 2000B HL01 010	Hierarchical ID Number	AN	1-12	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2000B.HL01 must be present.
X223 107 2000B HL01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2000B.HL01 must be 1-12 characters.
X223 107 2000B HL01 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2000B.HL01 must be numeric.
X223 107 2000B HL01 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	2000B.HL01 must = the value of the previous HL01 (2000A.HL01) plus one.
X223 107 2000B HL02 010	Hierarchical Parent ID Number	AN	1-12	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2000B.HL02 must be present.
X223 107 2000B HL02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	2000B.HL02 must = the value of the HL01 (2000A.HL01) of the parent HL.
X223 107 2000B HL03 010	Hierarchical Level Code	ID	1-2	R	N/A	22	999	IK403 = 1: "Required Data Element Missing"	2000B.HL03 must be present.
X223 107 2000B HL03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2000B.HL03 must be "22".
X223 107 2000B HL04 010	Hierarchical Child Code	ID	1-1	R	N/A	0, 1	999	IK403 = 1: "Required Data Element Missing"	2000B.HL04 must be present.
X223 107 2000B HL04 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2000B.HL04 must be "0".
X223 107 2000B HL04 030 Edit Deactivated	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732 "Information submitted inconsistent with billing guidelines." CSC 109 "Entity not eligible." EIC: 03 "Dependent"	2000B.HL04 must be "0".
X223 109 2000B SBR 010	SUBSCRIBER INFORMATION	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2000B.SBR must be present.
X223 109 2000B SBR 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2000B.SBR is allowed.
X223 109 2000B SBR01 010	Payer Responsibility Sequence Number Code	ID	1-1	R	N/A	A, B, C, D, E, F, G, H, P, S, T, U	999	IK403 = 1: "Required Data Element Missing"	2000B.SBR01 must be present.
X223 109 2000B SBR01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2000B.SBR01 must be "S" or "P" or "T".
X223 109 2000B SBR01 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732 "Information submitted inconsistent with billing guidelines." CSC 742 "Payer Responsibility Sequence Number Code."	N/A
X223 109 2000B SBR02 010	Individual Relationship Code	ID	2-2	S	N/A	18	999	IK403 = 1: "Required Data Element Missing"	2000B.SBR02 must be present.
X223 109 2000B SBR02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2000B.SBR02 must be "18".
X223 109 2000B SBR03 004	Insured Group or Policy Number	AN	1-50	S	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	2000B.SBR03 must not be present"
X223 109 2000B SBR03 006	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement/Rejected for relational field in error" CSC 163: "Entity's Policy Number" CSC 732 "Information submitted inconsistent with billing guidelines." EIC: IL "Subscriber"	N/A
X223 109 2000B SBR03 010 Edit Deactivated	Insured Group or Policy Number	AN	1-50	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2000B.SBR03 must contain at least one non-space character.
X223 109 2000B SBR03 020 Edit Deactivated	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2000B.SBR03 must be 1-50 characters.
X223 109 2000B SBR03 030 Edit Deactivated	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length Invalid" CSC 163: "Entity's Policy Number" EIC: IL Subscriber	N/A
X223 109 2000B SBR03 040 Edit Deactivated	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2000B.SBR03 must be populated with accepted AN characters.
X223 109 2000B SBR04 004	Insured Group Name	AN	1-60	S	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	2000B.SBR04 must not be present.
X223 109 2000B SBR04 007	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement/Rejected for relational field in error" CSC 663: "Entity's Group Name" CSC 732 "Information submitted inconsistent with billing guidelines." EIC: IL "Subscriber"	N/A
X223 109 2000B SBR05 010	Insurance Type Code	ID	1-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 109 2000B SBR06 010	Coordination of Benefits Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 109 2000B SBR07 010	Yes/No Condition or Response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 109 2000B SBR08 010	Employment Status Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 109 2000B SBR09 010	Claim Filing Indicator Code	ID	1-2	S	N/A	11, 12, 13, 14, 15, 16, 17, AM, BL, CH, CI, DS, FI, HM, LM, MA, MB, MC, OF, TV, VA, WC, ZZ	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732 "Information submitted inconsistent with billing guidelines." CSC 480 "Entity's claim filing indicator." EIC: PR "Payer"	2000B.SBR09 must be "MA".
X223 112 2010BA NM1 010	SUBSCRIBER NAME	N/A	1	R	1	N/A	999	IK304 = 3: "Required Segment Missing"	2010BA.NM1 must be present.
X223 112 2010BA NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2010BA.NM1 is allowed.
X223 112 2010BA NM101 010	Entity Identifier Code	ID	2-3	R	N/A	IL	999	IK403 = 1: "Required Data Element Missing"	2010BA.NM101 must be present.
X223 112 2010BA NM101 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BA.NM101 must be "IL".
X223 112 2010BA NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1, 2	999	IK403 = 1: "Required Data Element Missing"	2010BA.NM102 must be present.
X223 112 2010BA NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC741 "Entity must be a person." EIC: IL "Subscriber"	2010BA.NM102 must be "1".
X223 112 2010BA NM103 010	Subscriber Last Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BA.NM103 must be present.
X223 112 2010BA NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.NM103 must contain at least one non-space character.
X223 112 2010BA NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BA.NM103 must be 1-60 characters.
X223 112 2010BA NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: IL "Subscriber"	N/A
X223 112 2010BA NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.NM103 must be populated with accepted AN characters.
X223 112 2010BA NM104 010	Subscriber First Name	AN	1-35	S	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 505: "Entity's First Name" EIC: IL "Subscriber"	2010BA.NM104 must be present.
X223 112 2010BA NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.NM104 must contain at least one non-space character.
X223 112 2010BA NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BA.NM104 must be 1-35 characters.
X223 112 2010BA NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: IL "Subscriber"	N/A
X223 112 2010BA NM104 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.NM104 must be populated with accepted AN characters.
X223 112 2010BA NM104 070	Subscriber First Name	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 505: "Entity's First Name" EIC: IL "Subscriber"	First position of 2010BA.NM104 must not be numeric.
X223 112 2010BA NM105 010	Subscriber Middle Name	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.NM105 must contain at least one non-space character.
X223 112 2010BA NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BA.NM105 must be 1-25 characters.
X223 112 2010BA NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: IL "Subscriber"	N/A
X223 112 2010BA NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.NM105 must be populated with accepted AN characters.
X223 112 2010BA NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: IL "Subscriber"	The first position of 2010BA.NM105 must be alphabetic (A...Z).
X223 112 2010BA NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 112 2010BA NM107 010	Subscriber Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.NM107 must contain at least one non-space character.
X223 112 2010BA NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BA.NM107 must be 1-10 characters.
X223 112 2010BA NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: IL "Subscriber"	N/A
X223 112 2010BA NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.NM107 must be populated with accepted AN characters.
X223A2 15 2010BA NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	II, MI	999	IK403 = 1: "Required Data Element Missing"	2010BA.NM108 must be present.
X223 112 2010BA NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BA.NM108 must be "MI".
X223A2 16 2010BA NM109 010	Subscriber Primary Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BA.NM109 must be present.
X223 112 2010BA NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 164: "Entity's contract/member number" EIC: IL "Subscriber"	2010BA.NM109 must be 7 - 12 positions in the format of ANNNNNN AANNNNNN AAANNNNNN NNNNNNNNNA ANNNNNNNNN AANNNNNNNNN NNNNNNNNNAA NNNNNNNNNAN OR AAANNNNNNNNN where "A" represents an alpha character and "N" represents a numeric digit. If MBI: 2010BA.NM109 must be 11 positions in the format of C A AN N A AN N A A N N where "C" represents a constrained numeric 1 thru 9, "A" represents alphabetic character A - Z but excluding S, L, O, I, B, Z, "N" represents numeric 0 thru 9 and "AN" represents either "A" or "N".
X223 112 2010BA NM109 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 164: "Entity's contract/member number" EIC: IL "Subscriber"	If the HIC/MBI format is valid, and 2300 CLM05-1 is not = 11X, 32X or 41X OR 2300 CLM05-3 is not = 7, 8 or Q, then 2010BA.NM109 must be a valid HICN prior to the MBI transition start date, must be a valid HICN or valid MBI on or after the MBI transition start date, must be a valid MBI after the MBI transition end date based on the date in the +RC DTP segment.
X223 112 2010BA NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 112 2010BA NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 112 2010BA NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 115 2010BA N3 005	SUBSCRIBER ADDRESS	N/A	1	S	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	2010BA.N3 must be present when 2000B.SBR02 is "18".
X223 115 2010BA N3 010	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010BA.N3 is allowed.
X223 115 2010BA N301 010	Subscriber Address Line	AN	1-55	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BA.N301 must be present.
X223 115 2010BA N301 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.N301 must contain at least one non-space character.
X223 115 2010BA N301 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BA.N301 must be 1-55 characters.
X223 115 2010BA N301 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street Address" EIC: IL "Subscriber"	N/A
X223 115 2010BA N301 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.N301 must be populated with accepted AN characters.
X223 115 2010BA N302 020	Subscriber Address Line	AN	1-55	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If present 2010BA.N302 must contain at least one non-space character.
X223 115 2010BA N302 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BA.N302 must be 1-55 characters.
X223 115 2010BA N302 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street Address" EIC: IL "Subscriber"	N/A
X223 115 2010BA N302 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.N302 must be populated with accepted AN characters.
X223A2 17 2010BA N4 005	SUBSCRIBER CITY/STATE/ZIP CODE	N/A	1	S	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	2010BA.N4 must be present when 2000B.SBR02 is "18".
X223 116 2010BA N4 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010BA.N4 is allowed.
X223 116 2010BA N401 010	Subscriber City Name	AN	2-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BA.N401 must be present.
X223 116 2010BA N401 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.N401 must contain at least two non-space characters.
X223 116 2010BA N401 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2010BA.N401 must be 2-30 characters.
X223 116 2010BA N401 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 502: "Entity's City" EIC: IL "Subscriber"	N/A
X223 116 2010BA N401 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.N401 must be populated with accepted AN characters.
X223 116 2010BA N402 010	Subscriber State Code	ID	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010BA.N404 is not present, 2010BA.N402 must be present.
X223 116 2010BA N402 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 501: "Entity's State/Province" EIC: IL "Subscriber"	2010BA.N402 must be a valid state code.
X223 116 2010BA N403 010	Subscriber Postal Zone or ZIP Code	ID	3-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010BA.N404 is not present, 2010BA.N403 must be present.
X223 116 2010BA N403 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 500: "Entity's Postal/Zip Code" EIC: IL "Subscriber"	2010BA.N403 must be a valid postal/zip Code when N404 equals US or blank
X223 116 2010BA N404 010	Country Code	ID	2-3	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 680: "Entity's Country" EIC: IL "Subscriber"	2010BA.N404 must be a valid 2 character Country Code.
X223 116 2010BA N405 010	Location Qualifier	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 116 2010BA N406 010	Location Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 116 2010BA N407 010	Country Subdivision Code	ID	1-3	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 695: "Entity's Country Subdivision Code" EIC: IL "Subscriber"	2010BA.N407 must be a valid Country Subdivision Code.
X223 118 2010BA DMG 010	SUBSCRIBER DEMOGRAPHIC INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	2010BA.DMG must be present.
X223 118 2010BA DMG 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010BA.DMG is allowed.
X223 118 2010BA DMG01 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 1: "Required Data Element Missing"	2010BA.DMG01 must be present.
X223 118 2010BA DMG01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BA.DMG01 must be "D8".
X223 118 2010BA DMG02 010	Subscriber Birth Date	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 1: "Required Data Element Missing"	2010BA.DMG02 must be present.
X223 118 2010BA DMG02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	2010BA.DMG02 must be a valid date in CCYYMMDD format.
X223 118 2010BA DMG02 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 510: "Future date" CSC 158: "Entity's date of birth" EIC: IL "Subscriber"	2010BA.DMG02 must not be a future date.
X223 118 2010BA DMG03 010	Subscriber Gender Code	ID	1-1	R	N/A	F, M, U	999	IK403 = 1: "Required Data Element Missing"	2010BA.DMG03 must be present.
X223 118 2010BA DMG03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BA.DMG03 must be valid values.
X223 118 2010BA DMG04 010	Marital Status Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 118 2010BA DMG05 010	Race or Ethnicity Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 118 2010BA DMG06 010	Citizenship Status Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 118 2010BA DMG07 010	Country Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 118 2010BA DMG08 010	Basis of Verification Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 118 2010BA DMG09 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 118 2010BA DMG10 010	Code List Qualifier Code	ID	1-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 118 2010BA DMG11 010	Industry Code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 120 2010BA REF 010	SUBSCRIBER SECONDARY IDENTIFICATION	N/A	1	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: HK "Subscriber"	2010BA.REF with REF01 = "SY" must not be present.
X223 121 2010BA REF 010	PROPERTY AND CASUALTY CLAIM NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010BA.REF with REF01 = "Y4" is allowed.
X223 121 2010BA REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	Y4	999	IK403 = 1: "Required Data Element Missing"	2010BA.REF01 must be present.
X223 121 2010BA REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BA.REF01 must be "Y4".
X223 121 2010BA REF02 010	Property Casualty Claim Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BA.REF02 must be present.
X223 121 2010BA REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.REF02 must contain at least one non-space character.
X223 121 2010BA REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BA.REF02 must be 1-50 characters.
X223 121 2010BA REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 629: "Property Casualty Claim Number" EIC: IL "Subscriber"	N/A
X223 121 2010BA REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BA.REF02 must be populated with accepted AN characters.
X223 121 2010BA REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 121 2010BA REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 122 2010BB NM1 010	PAYER NAME	N/A	1	R	1	N/A	999	IK304 = 3: "Required Segment Missing"	2010BB.NM1 must be present.
X223 122 2010BB NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2010BB.NM1 is allowed.
X223 122 2010BB NM101 010	Entity Identifier Code	ID	2-3	R	N/A	PR	999	IK403 = 1: "Required Data Element Missing"	2010BB.NM101 must be present.
X223 122 2010BB NM101 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BB.NM101 must be "PR".
X223 122 2010BB NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	2	999	IK403 = 1: "Required Data Element Missing"	2010BB,NM102 must be present.
X223 122 2010BB NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BB.NM102 must be "2".
X223 122 2010BB NM103 010	Payer Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BB.NM103 must be present.
X223 122 2010BB NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.NM103 must contain at least one non-space character.
X223 122 2010BB NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BB.NM103 must be 1-60 characters.
X223 122 2010BB NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: PR "Payer"	N/A
X223 122 2010BB NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.NM103 must be populated with accepted AN characters.
X223 122 2010BB NM104 010	Name First	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 122 2010BB NM105 010	Name Middle	AN	1-25	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 122 2010BB NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 122 2010BB NM107 010	Name Suffix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 122 2010BB NM108 010	Identification Code Qualifier	ID	1-2	R	N/A	PI, XV	999	IK403 = 1: "Required Data Element Missing"	2010BB.NM108 must be present.
X223 122 2010BB NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BB.NM108 must be "PI".
X223 122 2010BB NM109 010	Payer Identifier	AN	2-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BB.NM109 must be present.
X223 122 2010BB NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.NM109 must contain at least two non-space characters.
X223 122 2010BB NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2010BB.NM109 must be 2-80 characters.
X223 122 2010BB NM109 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 53: "Entity ID Number" EIC: PR "Payer"	N/A
X223 122 2010BB NM109 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.NM109 must be populated with accepted AN characters.
X223 122 2010BB NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 122 2010BB NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 122 2010BB NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 124 2010BB N3 010	PAYER ADDRESS	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010BB.N3 is allowed.
X223 124 2010BB N301 010	Payer Address Line	AN	1-55	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BB.N301 must be present.
X223 124 2010BB N301 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.N301 must contain at least one non-space character.
X223 124 2010BB N301 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BB.N301 must be 1-55 characters.
X223 124 2010BB N301 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street Address" EIC: PR "Payer"	N/A
X223 124 2010BB N301 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.N301 must be populated with accepted AN characters.
X223 124 2010BB N302 020	Payer Address Line	AN	1-55	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If present, 2010BB.N302 must contain at least one non-space character.
X223 124 2010BB N302 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BB.N302 must be 1-55 characters.
X223 124 2010BB N302 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street Address" EIC: PR "Payer"	N/A
X223 124 2010BB N302 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.N302 must be populated with accepted AN characters.
X223 125 2010BB N4 020	PAYER CITY/STATE/ZIP CODE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010BB.N4 is allowed.
X223 125 2010BB N401 010	Payer City Name	AN	2-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BB.N401 must be present.
X223 125 2010BB N401 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.N401 Must contain at least two non-space characters.
X223 125 2010BB N401 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2010BB.N401 must be 2-30 characters.
X223 125 2010BB N401 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 502: "Entity's City" EIC: PR "Payer"	N/A
X223 125 2010BB N401 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.N401 must be populated with accepted AN characters.
X223 125 2010BB N402 010	Payer State Code	ID	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010BB.N404 is not present, 2010BB.N402 must be present.
X223 125 2010BB N402 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 501: "Entity's State/Province" EIC: PR "Payer"	2010BB.N402 must be a valid state code.
X223 125 2010BB N403 010	Payer Postal Zone or ZIP Code	ID	3-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2010BB.N404 is not present, 2010BB.N403 must be present.
X223 125 2010BB N403 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 500: "Entity's Postal/Zip Code" EIC: PR "Payer"	2010BB.N403 must be a valid zip code.
X223 125 2010BB N404 010	Country Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 125 2010BB N405 010	Location Qualifier	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 125 2010BB N406 010	Location Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 125 2010BB N407 010	Country Subdivision Code	ID	1-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 127 2010BB REF 010	PAYER SECONDARY IDENTIFICATION	N/A	3	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: PR "Payer"	2010BB.REF with REF01 = "2U", "EI", "FY", or "NF" must not be present.
X223 129 2010BB REF 010	BILLING PROVIDER SECONDARY IDENTIFICATION	N/A	1	S	N/A	N/A	999	IK304 = 2: "Unexpected Segment"	2010BB.REF with REF01 = "G2" must be present when 2010AA.NM109 is not present.
X223 129 2010BB REF 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2010BB.REF with REF01 = "G2" is allowed.
X223 129 2010BB REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2010BB.REF must not be present.
X223 129 2010BB REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	G2, LU	999	IK403 = 1: "Required Data Element Missing"	2010BB.REF01 must be present.
X223 129 2010BB REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2010BB.REF01 must be valid values.
X223 129 2010BB REF02 010	Payer Additional Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2010BB.REF02 must be present.
X223 129 2010BB REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.REF02 must contain at least one-none space character.
X223 129 2010BB REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2010BB.REF02 must be 1-50 characters.
X223 129 2010BB REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 560: "Entity's Additional/Secondary Identifier" EIC: PR "Payer"	N/A
X223 129 2010BB REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2010BB.REF02 must be populated with accepted AN characters.
X223 129 2010BB REF02 070	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	2010BB.REF02 billing provider must be "associated" to the submitter (from a trading partner management perspective) in 1000A.NM109.
X223 129 2010BB REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 129 2010BB REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 131 2000C HL 010	PATIENT HIERARCHICAL LEVEL	N/A	1	S	>1	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2000C.HL must not be present.
X223 133 2000C PAT 010	PATIENT INFORMATION	ID	1	R	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2000C.PAT must not be present.
X223 135 2010CA NM1 010	PATIENT NAME	ID	1	R	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2010CA.NM1 must not be present.
X223 137 2010CA N3 010	PATIENT ADDRESS	N/A	1	R	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2010CA.N3 must not be present.
X223 138 2010CA N4 010	PATIENT CITY/STATE/ZIP CODE	N/A	1	R	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2010CA.N4 must not be present.
X223 140 2010CA DMG 010	PATIENT DEMOGRAPHIC INFORMATION	N/A	1	R	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2010CA.DMG must not be present.
X223 142 2010CA REF 010	PROPERTY AND CASUALTY CLAIM NUMBER	N/A	1	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2010CA.REF with REF01 = "Y4" must not be present.
X223A2 19 2010CA REF 010	PROPERTY AND CASUALTY PATIENT IDENTIFIER	N/A	1	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2010CA.REF with REF01 = "1W" or "SY" must not be present.
X223 143 2300 CLM 010	CLAIM INFORMATION Loop	N/A	N/A	N/A	100	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only 100 iterations of the 2300 loop are allowed.
X223 143 2300 CLM 020	CLAIM INFORMATION	N/A	1	R	1	N/A	999	IK304 = 3: "Required Segment Missing" OR IK304 = I7: "Implementation Loop Occurs Under Minimum Times"	2300.CLM must be present.
X223 143 2300 CLM 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only 1 iteration of 2300.CLM is allowed.
X223 143 2300 CLM01 010	Patient Control Number	AN	1-38	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.CLM01 must be present.
X223 143 2300 CLM01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.CLM01 must contain at least one-non-space character.
X223 143 2300 CLM01 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.CLM01 must be 1 - 38 characters.
X223 143 2300 CLM01 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 478: Claim submitter's identifier (patient account number) is missing.	N/A
X223 143 2300 CLM01 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.CLM01 must be populated with accepted AN characters.
X223 143 2300 CLM02 010	Total Claim Charge Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.CLM02 must be present.
X223 143 2300 CLM02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.CLM02 must be numeric.
X223 143 2300 CLM02 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.CLM02 must be >= 0 and <= 99,999,999.99.
X223 143 2300 CLM02 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 178: "Submitted Charges"	N/A
X223 143 2300 CLM02 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 178: "Submitted Charges"	2300.CLM02 is limited to 0, 1 or 2 decimal positions.
X223 143 2300 CLM02 070	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 400: "Claim is out of balance" CSC 178: "Submitted Charges"	2300.CLM02 must = the sum of all 2400.SV203 amounts.
X223 143 2300 CLM02 080	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 400: "Claim is out of Balance" CSC 672 "Payer's payment information is out of balance"	CLM02 must = the sum of all 2320 CAS amounts & all 2430 CAS amounts and the 2320 AMT02 (when AMT01=D) for each other payer occurrence.
X223 143 2300 CLM03 010	Claim Filing Indicator Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM04 010	Non-Institutional Claim Type Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM05-1 010	Facility Type Code	AN	1-2	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.CLM05-1 must be present.
X223 143 2300 CLM05-1 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 228: "Type of bill for UB claim"	2300.CLM05-1 must be the 1st and 2nd positions of a valid Uniform Bill Type Code.
X223 143 2300 CLM05-1 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 228: "Type of bill for UB claim"	If BHT04 is on or after October 1, 2013, 2300.CLM05-1 must not = "33".
X223 143 2300 CLM05-1 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement /Rejected for Missing Information..." CSC 232: "Admitting diagnosis"	If 2300.CLM05-1 = 11, 12, 18, 21, 22, or 41, 2300.HI with HI01-1 = "BJ" or "ABJ" must be present.
X223 143 2300 CLM05-2 010	Facility Code Qualifier	ID	1-2	R	N/A	A	999	IK403 = 1: "Required Data Element Missing"	2300.CLM05-2 must be present.
X223 143 2300 CLM05-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.CLM05-2 must be "A".
X223 143 2300 CLM05-3 010	Claim Frequency Code	ID	1-1	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.CLM05-3 must be present.
X223 143 2300 CLM05-3 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 228:"Type of bill for UB claim"	2300.CLM05-3 must be the 3rd position of a valid Uniform Bill Type Code.
X223 143 2300 CLM06 010	Provider or Supplier Signature Indicator	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM07 010	Medicare Assignment Code	ID	1-1	R	N/A	A, B, C	999	IK403 = 1: "Required Data Element Missing"	2300.CLM07 must be present.
X223 143 2300 CLM07 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.CLM07 must be valid values.
X223 143 2300 CLM08 010	Benefits Assignment Certification Indicator	ID	1-1	R	N/A	N, W, Y	999	IK403 = 1: "Required Data Element Missing"	2300.CLM08 must be present.
X223 143 2300 CLM08 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.CLM08 must be valid values.
X223 143 2300 CLM09 010	Release of Information Code	ID	1-1	R	N/A	I, Y	999	IK403 = 1: "Required Data Element Missing"	2300.CLM09 must be present.
X223 143 2300 CLM09 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.CLM09 must be valid values.
X223 143 2300 CLM10 010	Patient Signature Source Code	ID	1-1	N/U	N/A	P	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM11 010	RELATED CAUSES INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM12 010	Special Program Indicator	ID	2-3	N/U	N/A	02, 03, 05, 09	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM13 010	Yes/No Condition or Response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM14 010	Level of Service Code	ID	1-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM15 010	Yes/No Condition or Response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM16 010	Participation Agreement	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM17 010	Claim Status Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM18 010	Yes/No Condition or Response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM19 010	Claim Submission Reason Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 143 2300 CLM20 010	Delay Reason Code	ID	1-2	S	N/A	1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 15	999	IK403 = 7: "Invalid Code Value"	2300.CLM20 must be valid values.
X223 149 2300 DTP 020	DATE - DISCHARGE HOUR	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.DTP with DTP01 = "096" is allowed.
X223 149 2300 DTP01 010	Date Time Qualifier	ID	3-3	R	N/A	096	999	IK403 = 1: "Required Data Element Missing"	2300.DTP01 must be present.
X223 149 2300 DTP01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.DTP01 must be "096".
X223 149 2300 DTP02 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	TM	999	IK403 = 1: "Required Data Element Missing"	2300.DTP02 must be present.
X223 149 2300 DTP02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.DTP02 must be "TM".
X223 149 2300 DTP03 010	Discharge Hour	AN	1-35	R	N/A	HHMM	999	IK403 = 1: "Required Data Element Missing"	2300.DTP03 must be present.
X223 149 2300 DTP03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 9: "Invalid Time"	2300.DTP03 must be a valid time in HHMM format.
X223 150 2300 DTP 010	DATE - STATEMENT DATES	ID	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2300.DTP must be present.
X223 150 2300 DTP 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.DTP with DTP01 = "434" is allowed.
X223 150 2300 DTP01 010	Date Time Qualifier	ID	3-3	R	N/A	434	999	IK403 = 1: "Required Data Element Missing"	2300.DTP01 must be present.
X223 150 2300 DTP01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.DTP01 must be "434".
X223 150 2300 DTP02 010	Date Time Period Format Qualifier	AN	2-3	R	N/A	RD8	999	IK403 = 1: "Required Data Element Missing"	2300.DTP02 must be present.
X223 150 2300 DTP02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.DTP02 must be "RD8".
X223 150 2300 DTP03 010	Statement From or To Date	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 1: "Required Data Element Missing"	2300.DTP03 must be present.
X223 150 2300 DTP03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	2300.DTP03 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 150 2300 DTP03 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 164: "Entity's contract/member number" EIC: IL "Subscriber" CSC: 188 "Statement from-through dates."	If 2300 CLM05-1 is = 11X, 32X or 41X, and 2300 CLM05-3 is not = 7, 8 or Q, 2010BA NM109 must be a valid MBI when the first date in 2300 DTP02, (DTP01 = 434), is greater than the MBI transition end date.
X223 150 2300 DTP03 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 510: "Future date" CSC 188: "Statement from-through date"	2300.DTP03 must not be a future date.
X223 151 2300 DTP 020	DATE - ADMISSION DATE/HOUR	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.DTP with DTP01 = "435" is allowed.
X223 151 2300 DTP01 010	Date Time Qualifier	ID	3-3	R	N/A	435	999	IK403 = 1: "Required Data Element Missing"	2300.DTP01 must be present.
X223 151 2300 DTP01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.DTP01 must be "435".
X223 151 2300 DTP02 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8, DT	999	IK403 = 1: "Required Data Element Missing"	2300.DTP02 must be present.
X223 151 2300 DTP02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.DTP02 must be valid values.
X223 151 2300 DTP03 010	Admission Date and Hour	AN	1-35	R	N/A	CCYYMMDD, CCYYMMDDHHMM	999	IK403 = 1: "Required Data Element Missing"	2300.DTP03 must be present.
X223 151 2300 DTP03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	If 2300.DTP02 = D8, then 2300.DTP03 must be a valid date in CCYYMMDD format.
X223 151 2300 DTP03 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	If 2300.DTP02 = DT, then 2300.DTP03 must be a valid date in CCYYMMDDHHMM format.
X223 151 2300 DTP03 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 510: "Future date" CSC 189: "Facility admission date"	2300.DTP03 must not be a future date.
X223 152 2300 DTP 010	DATE - REPRICER RECEIVED DATE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.DTP is allowed.
X223 152 2300 DTP01 010	Date Time Qualifier	ID	3-3	R	N/A	050	999	IK403 = 1: "Required Data Element Missing"	2300.DTP01 must be present.
X223 152 2300 DTP01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.DTP01 must be "050".
X223 152 2300 DTP02 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 1: "Required Data Element Missing"	2300.DTP02 must be present.
X223 152 2300 DTP02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.DTP02 must be "D8".
X223 152 2300 DTP03 010	Order Date	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 1: "Required Data Element Missing"	2300.DTP03 must be present.
X223 152 2300 DTP03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	2300.DTP03 must be a valid date in CCYYMMDD format.
X223 153 2300 CL1 010	INSTITUTIONAL CLAIM CODE	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2300.CL1 must be present.
X223 153 2300 CL1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.CL1 is allowed.
X223A2 20 2300 CL101 010	Priority (Type) of Admission or Visit Code	ID	1-1	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.CL101 must be present.
X223 153 2300 CL101 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.CL101 must be 1 character.
X223 153 2300 CL101 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 231: "Hospital admission type"	2300.CL101 must be a valid Priority (Type) of Admission or Visit code on the receipt date and is within the codes effective and termination date.
X223A2 20 2300 CL102 010	Point of Origin for Admission or Visit Code	ID	1-1	S	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.CL102 must be present when 2300.CLM05-1 is not "14".
X223 153 2300 CL102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.CL102 must be 1 character.
X223 153 2300 CL102 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 229: "Hospital admission source"	2300.CL102 must be a valid Point of Origin for Admission or Visit Code on the receipt date and is within the codes effective and termination date.
X223 153 2300 CL103 010	Patient Status Code	ID	1-2	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.CL103 must be present.
X223 153 2300 CL103 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 234: "Patient discharge status"	When 2300.CL103 value "20", "40", "41", or "42" is present, at least one occurrence of 2300.HI01-2 thru HI12-2 must = "55" where HI01-1 is "BH".
X223 153 2300 CL103 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 234: "Patient discharge status"	2300.CL103 must be a valid Patient Status Code on the receipt date and is within the codes effective and termination date.
X223 153 2300 CL104 010	Nursing Home Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 154 2300 PWK 010	CLAIM SUPPLEMENTAL INFORMATION	N/A	10	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only ten iterations of 2300.PWK are allowed.
X223 154 2300 PWK01 010	Attachment Report Type Code	ID	2-2	R	N/A	03, 04, 05, 06, 07, 08, 09, 10, 11, 13, 15, 21, A3, A4, AM, AS, B2, B3, B4, BR, BS, BT, CB, CK, CT, D2, DA, DB, DG, DJ, DS, EB, HC, HR, I5, IR, LA, M1, MT, NN, OB, OC, OD, OE, OX, OZ, P4, P5, PE, PN, PO, PQ, PY, PZ, RB, RR, RT, RX, SG, V5, XP	999	IK403 = 1: "Required Data Element Missing"	2300.PWK01 must be present.
X223 154 2300 PWK01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.PWK01 must be valid values.
X223 154 2300 PWK02 010	Attachment Transmission Code	ID	1-2	R	N/A	AA, BM, EL, EM, FT, FX	999	IK403 = 1: "Required Data Element Missing"	2300.PWK02 must be present.
X223 154 2300 PWK02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.PWK02 must be valid values.
X223 154 2300 PWK03 010	Report Copies Needed	N0	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 154 2300 PWK04 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 154 2300 PWK05 010	Identification Code Qualifier	ID	1-2	S	N/A	AC	999	IK403 = 2:"Conditional Required Data Element Missing"	When 2300.PWK05 is present, 2300.PWK02 must be "BM", "EL", "EM", "FX" or "FT" .
X223 154 2300 PWK05 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.PWK05 must be "AC".
X223 154 2300 PWK06 010	Attachment Control Number	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	When 2300.PWK06 is present, 2300.PWK02 must be "BM", "EL", "EM", "FX" or "FT" .
X223 154 2300 PWK06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2300.PWK06 must be 2-50 characters.
X223 154 2300 PWK06 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 489: "Attachment Control Number"	N/A
X223 154 2300 PWK06 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.PWK06 must be populated with accepted AN characters.
X223 154 2300 PWK06 060	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.PWK06 must contain at least two non-space characters.
X223 154 2300 PWK07 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 154 2300 PWK08 010	ACTIONS INDICATED	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 154 2300 PWK09 010	Request Category Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 158 2300 CN1 010	CONTRACT INFORMATION	ID	1	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2300.CN1 must not be present.
X223 160 2300 AMT 010	PATIENT ESTIMATED AMOUNT DUE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.AMT is allowed.
X223 160 2300 AMT01 010	Amount Qualifier Code	ID	1-3	R	N/A	F3	999	IK403 = 1: "Required Data Element Missing"	2300.AMT01 must be present.
X223 160 2300 AMT01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.AMT01 must be "F3".
X223 160 2300 AMT02 010	Patient Responsibility Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.AMT02 must be present.
X223 160 2300 AMT02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	AMT02 must be numeric.
X223 160 2300 AMT02 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.AMT02 must be >= 0 and <=99,999,999.99.
X223 160 2300 AMT02 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 565: "Estimated Claim Due Amount" EIC: QC "Patient"	N/A
X223 160 2300 AMT02 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 565: "Estimated Claim Due Amount" EIC: QC "Patient"	2300.AMT02 is limited to 0, 1 or 2 decimal positions.
X223 160 2300 AMT03 010	Credit/Debit Flag Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 161 2300 REF 010	SERVICE AUTHORIZATION EXCEPTION CODE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "4N" is allowed.
X223 161 2300 REF01 010	Reference Identification Qualifier	N/A	N/A	N/A	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 161 2300 REF01 020	N/A	ID	2-3	R	N/A	4N	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "4N".
X223 161 2300 REF02 030	Service Authorization Exception Code	ID	1-50	R	N/A	1, 2, 3, 4, 5, 6, 7	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 161 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF02 must be valid values.
X223 161 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 161 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 163 2300 REF 010	REFERRAL NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "9F" is allowed.
X223 163 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	9F	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 163 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "9F".
X223 163 2300 REF02 010	Prior Authorization or Referral Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 163 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 163 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 163 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 252: "Entity's authorization/certification number" EIC: PR "Payer"	N/A
X223 163 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 163 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 163 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 164 2300 REF 010	PRIOR AUTHORIZATION	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "G1" is allowed.
X223 164 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	G1	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 164 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "G1".
X223 164 2300 REF02 010	Prior Authorization Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 164 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 164 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 164 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 252: "Entity's authorization/certification number" EIC: 85 "Billing Provider"	N/A
X223 164 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 164 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 164 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 166 2300 REF 010	PAYER CLAIM CONTROL NUMBER	ID	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "F8" is allowed.
X223 166 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	F8	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 166 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "F8".
X223 166 2300 REF02 010	PAYER CLAIM CONTROL NUMBER	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 166 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 166 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 166 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 464: "Payer Assigned Claim Control Number"	N/A
X223 166 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 166 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 166 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 167 2300 REF 010	REPRICED CLAIM NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "9A" is allowed.
X223 167 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	9A	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 167 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "9A".
X223 167 2300 REF02 010	Repriced Claim Reference Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 167 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 167 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 167 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 702: "Repriced Claim Reference Number"	N/A
X223 167 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 167 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 167 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 168 2300 REF 010	ADJUSTED REPRICED CLAIM NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "9C" is allowed.
X223 168 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	9C	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 168 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "9C".
X223 168 2300 REF02 010	Adjusted Repriced Claim Reference Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 168 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 168 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 168 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 517: "Adjusted Repriced Claim Reference Number"	N/A
X223 168 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 168 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 168 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 169 2300 REF 010	INVESTIGATIONAL DEVICE EXEMPTION NUMBER	N/A	5	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "LX" is allowed.
X223 169 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	LX	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 169 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "LX".
X223 169 2300 REF02 010	Investigational Device Exemption Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 169 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 169 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 169 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 579: "Investigational Device Exemption Identifier"	N/A
X223 169 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 169 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 169 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 170 2300 REF 010	CLAIM IDENTIFIER FOR TRANSMISSION INTERMEDIARIES	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "D9" is allowed.
X223 170 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	D9	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 170 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "D9"
X223 170 2300 REF02 010	Value Added Network Trace Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 170 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 170 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-20 characters.
X223 170 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 543: "Clearinghouse or Value Added Network Trace"	N/A
X223 170 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 170 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 170 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 172 2300 REF 010	AUTO ACCIDENT STATE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "LU" is allowed.
X223 172 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	LU	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 172 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "LU".
X223 172 2300 REF02 010	Auto Accident State or Province	AN	1-50	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 501: "Entity's State/Province" CSC 171: Other insurance coverage information (health, liability, auto, etc.) EIC: PR "Payer"	2300.REF02 must be a valid State or Providence code.
X223 172 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 172 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 173 2300 REF 010	MEDICAL RECORD NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "EA" is allowed.
X223 173 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	EA	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 173 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "EA".
X223 173 2300 REF02 010	Medical Record Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 173 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 173 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 173 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 588: "medical Record Number"	N/A
X223 173 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 173 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 173 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 174 2300 REF 010	DEMONSTRATION PROJECT IDENTIFIER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "P4" is allowed.
X223 174 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	P4	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 174 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "P4".
X223 174 2300 REF02 010	Demonstration Project Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 174 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 174 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 174 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 556: "Demonstration Project Identifier"	N/A
X223 174 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: Information submitted inconsistent with billing guidelines CSC 556: Demonstration Project Identifier	If 2300.REF02 (REF01=P4) is a valid VA demonstration project identifier, 1000B.NM109 must be the contractor number for the current contractor responsible for processing the VA MRA project claims.
X223 174 2300 REF02 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: Information submitted inconsistent with billing guidelines CSC 556: Demonstration Project Identifier	2300 REF02 (when REF01=P4) must not contain the value 74.
X223 174 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 174 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 175 2300 REF 010	PEER REVIEW ORGANIZATION (PRO) APPROVAL NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.REF with REF01 = "G4" is allowed.
X223 175 2300 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	G4	999	IK403 = 1: "Required Data Element Missing"	2300.REF01 must be present.
X223 175 2300 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.REF01 must be "G4".
X223 175 2300 REF02 010	PRO Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.REF02 must be present.
X223 175 2300 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 175 2300 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.REF02 must be 1-50 characters.
X223 175 2300 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 611: "Peer Review Authorization Number"	N/A
X223 175 2300 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must be populated with accepted AN characters.
X223 175 2300 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 175 2300 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 176 2300 K3 010	FILE INFORMATION	N/A	10	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only ten iterations of K3 are allowed.
X223 176 2300 K301 010	Fixed Format Information	AN	1-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.K301 must be present.
X223 176 2300 K301 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.K301 must contain at least one non-space character.
X223 176 2300 K301 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.K301 must be 1-80 characters.
X223 176 2300 K301 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 569: "Fixed Format Information"	N/A
X223 176 2300 K301 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.K301 must be populated with accepted AN characters.
X223 176 2300 K302 010	Record Format Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 176 2300 K303 010	COMPOSITE UNIT OF MEASURE	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 178 2300 NTE 010	CLAIM NOTE	N/A	10	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only ten iterations of 2300.NTE are allowed.
X223 178 2300 NTE01 010	Note Reference Code	ID	3-3	R	N/A	ALG, DCP, DGN, DME, MED, NTR, ODT, RHB, RLH, RNH, SET, SFM, SPT, UPI	999	IK403 = 1: "Required Data Element Missing"	2300.NTE01 must be present.
X223 178 2300 NTE01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.NTE01 must be valid values.
X223 178 2300 NTE02 010	Claim Note Text	AN	1-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.NTE02 must be present.
X223 178 2300 NTE02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.NTE02 must be at least one non-space character.
X223 178 2300 NTE02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.NTE02 must be 1-80 characters.
X223 178 2300 NTE02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 297: "Medical Notes/Report"	N/A
X223 178 2300 NTE02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.NTE02 must be populated with accepted AN characters.
X223 180 2300 NTE 010	BILLING NOTE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.NTE is allowed.
X223 180 2300 NTE01 010	Note Reference Code	ID	3-3	R	N/A	ADD	999	IK403 = 1: "Required Data Element Missing"	2300.NTE01 must be present.
X223 180 2300 NTE01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.NTE01 must be "ADD".
X223 180 2300 NTE02 010	Billing Note Text	AN	1-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.NTE02 must be present.
X223 180 2300 NTE02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.NTE02 must be at least one non-space character.
X223 180 2300 NTE02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.NTE02 must be 1-80 characters.
X223 180 2300 NTE02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 704: "Claim Note Text"	N/A
X223 180 2300 NTE02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.NTE02 must be populated with accepted AN characters.
X223 181 2300 CRC 010	EPSDT REFERRAL	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.CRC with CRC01 = "ZZ" is allowed.
X223 181 2300 CRC01 010	Code Category	ID	2-2	R	N/A	ZZ	999	IK403 = 1: "Required Data Element Missing"	2300.CRC01 must be present.
X223 181 2300 CRC01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.CRC01 must be "ZZ".
X223 181 2300 CRC02 010	Certification Condition Indicator	ID	1-1	R	N/A	N, Y	999	IK403 = 1: "Required Data Element Missing"	2300.CRC02 must be present.
X223 181 2300 CRC02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.CRC02 must be valid values.
X223 181 2300 CRC03 010	Condition Code	ID	2-3	R	N/A	AV, NU, S2, ST	999	IK403 = 1: "Required Data Element Missing"	2300.CRC03 must be present.
X223 181 2300 CRC03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.CRC03 must be valid values.
X223 181 2300 CRC03 025	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	If 2300.CRC02 is "N", 2300.CRC03 must be "NU".
X223 181 2300 CRC04 010	Condition Code	ID	2-3	S	N/A	AV, NU, S2, ST	999	IK403 = 7: "Invalid Code Value"	2300.CRC04 must be valid values.
X223 181 2300 CRC05 010	Condition Code	ID	2-3	S	N/A	AV, NU, S2, ST	999	IK403 = 7: "Invalid Code Value"	2300.CRC05 must be valid values.
X223 181 2300 CRC06 010	Condition Indicator	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 181 2300 CRC07 010	Condition Indicator	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI 010	PRINCIPAL DIAGNOSIS	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2300.HI with HI01-1 = "BK" or "ABK" must be present.
X223 184 2300 HI 013	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 255: "Diagnosis Code"	If 2300.HI with HI01-1 = "BK" all applicable diagnosis and procedure code HI segments must contain only ICD-9 qualifiers.
X223 184 2300 HI 016	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 255: "Diagnosis Code"	If 2300.HI with HI01-1 = "ABK" all applicable diagnosis and procedure code HI segments must contain only ICD-10 qualifiers.
X223 184 2300 HI 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.HI with HI01-1 = "BK" or "ABK" is allowed.
X223 184 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABK, BK	999	IK403 = 1: "Required Data Element Missing"	2300.HI01-1 must be present.
X223 184 2300 HI01-1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be valid values.
X223 184 2300 HI01-2 010	Industry Code	AN	1-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2300.HI01-2 must be present.
X223 184 2300 HI01-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 254: "Principal diagnosis code"	If 2300.HI01-1 is "BK" then 2300.HI01-2 must be a valid ICD-9 Diagnosis code.
X223 184 2300 HI01-2 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 254: "Principal diagnosis code"	If 2300.HI01-1 is "ABK" then 2300.HI01-2 must be a valid ICD-10 Diagnosis code.
X223 184 2300 HI01-2 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-2 must not contain a ".".
X223 184 2300 HI01-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 254: "Principal diagnosis code"	N/A
X223 184 2300 HI01-2 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 254: Principal Diagnosis Code CSC 509: E-Code	If 2300.HI01-1 = BK then 2300.HI01-2 must not begin with "E".
X223 184 2300 HI01-2 065	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 254: "Principal diagnosis code" CSC 509: External Cause of Injury	If 2300.HI01-1 = ABK, then 2300.HI01-2 must not begin with a "V", "W", "X" or "Y".
X223 184 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI01-9 010	Present on Admission indicator	ID	1-1	N/U	N/A	N, U, W, Y	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 184 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI 050	ADMITTING DIAGNOSIS	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.HI with HI01-1 = "BJ" or "ABJ" is allowed.
X223 187 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 187 2300 HI01-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABJ, BJ	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be valid values.
X223 187 2300 HI01-2 010	Admitting Diagnosis Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 232: "Admitting Diagnosis"	If 2300.HI01-1 is "BJ" then 2300.HI01-2 must be a valid ICD-9 Diagnosis code.
X223 187 2300 HI01-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 232: "Admitting Diagnosis"	If 2300.HI01-1 is "ABJ" then 2300.HI01-2 must be a valid ICD-10 Diagnosis code.
X223 187 2300 HI01-2 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 232: "Admitting Diagnosis" CSC 509: "External Cause of Injury"	If 2300.HI01-1 = "ABJ", then 2300.HI01-2 must not begin with a "V", "W", "X" or "Y".
X223 187 2300 HI01-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-2 must not contain a ".".
X223 187 2300 HI01-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 232: "Admitting Diagnosis"	N/A
X223 187 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI01-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 187 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI 050	PATIENT REASON FOR VISIT	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.HI with HI01-1 = "PR" or "APR" is allowed.
X223 189 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 189 2300 HI01-1 010	Diagnosis Type Code	ID	1-3	R	N/A	APR, PR	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be valid values.
X223 189 2300 HI01-1 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 228: "Type of bill for UB claim"	If 2300 HI01-1 = 'PR' or 'APR', 2300.CLM05-1 must not = 11, 18, 21, or 41
X223 189 2300 HI01-2 010	Patient Reason For Visit	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient reason for visit"	If 2300.HI01-1 is "PR" then 2300.HI01-2 must be a valid ICD-9 Patient Reason for Visit code.
X223 189 2300 HI01-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient reason for visit"	If 2300.HI01-1 is "APR" then 2300.HI01-2 must be a valid ICD-10 Patient Reason for Visit code.
X223 189 2300 HI01-2 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient Reason for Visit" CSC 509: "External Cause of Injury"	If 2300.HI01-1 = "APR", then 2300.HI01-2 must not begin with a "V", "W", "X" or "Y".
X223 189 2300 HI01-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-2 must not contain a ".".
X223 189 2300 HI01-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 673: "Patient reason for visit"	N/A
X223 189 2300 HI01-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient reason for visit"	If 2300 HI01-1 is APR or PR the patient reason for visit codes in this HI segment cannot be duplicated.
X223 189 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2:"Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 189 2300 HI02-1 010	Diagnosis Type Code	ID	1-3	R	N/A	APR, PR	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be valid values.
X223 189 2300 HI02-2 010	Patient Reason For Visit	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient reason for visit"	If 2300.HI02-1 is "PR" then 2300.HI02-2 must be a valid ICD-9 Patient Reason for Visit code.
X223 189 2300 HI02-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient reason for visit"	If 2300.HI02-1 is "APR" then 2300.HI02-2 must be a valid ICD-10 Patient Reason for Visit code.
X223 189 2300 HI02-2 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient Reason for Visit" CSC 509: "External Cause of Injury"	If 2300.HI02-1 = "APR", then 2300.HI02-2 must not begin with a "V", "W", "X" or "Y".
X223 189 2300 HI02-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI02-2 must not contain a ".".
X223 189 2300 HI02-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 673: "Patient reason for visit"	N/A
X223 189 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI02-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI02-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI02-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2:"Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 189 2300 HI03-1 010	Diagnosis Type Code	ID	1-3	R	N/A	APR, PR	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be valid values.
X223 189 2300 HI03-2 010	Patient Reason For Visit	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient reason for visit"	If 2300.HI03-1 is "PR" then 2300.HI03-2 must be a valid ICD-9 Patient Reason for Visit code.
X223 189 2300 HI03-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient reason for visit"	If 2300.HI03-1 is "APR" then 2300.HI03-2 must be a valid ICD-10 Patient Reason for Visit code.
X223 189 2300 HI03-2 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 673: "Patient Reason for Visit" CSC 509: "External Cause of Injury"	If 2300.HI03-1 = "APR", then 2300.HI03-2 must not begin with a "V", "W", "X" or "Y".
X223 189 2300 HI03-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI03-2 must not contain a ".".
X223 189 2300 HI03-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 673: "Patient reason for visit"	N/A
X223 189 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI03-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI03-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI03-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 189 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI 010	EXTERNAL CAUSE OF INJURY	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.HI with HI01-1 = "BN" or "ABN" is allowed.
X223 193 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 193 2300 HI01-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be valid values.
X223 193 2300 HI01-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI01-1 is "BN" then 2300.HI01-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI01-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI01-1 is "ABN" then 2300.HI01-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI01-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-2 must not contain a ".".
X223 193 2300 HI01-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI01-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI01-1 = BN then 2300.HI01-2 must begin with "E".
X223 193 2300 HI01-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI01-1 = "ABN", then 2300.HI01-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI01-2 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI01-1 is "BN" or "ABN" the External Cause of Injury codes in this HI segment cannot be duplicated.
X223 193 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI01-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI01-9 must be valid values.
X223 193 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2:"Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 193 2300 HI02-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be valid values.
X223 193 2300 HI02-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI02-1 is "BN" then 2300.HI02-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI02-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI02-1 is "ABN" then 2300.HI02-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI02-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI02-2 must not contain a ".".
X223 193 2300 HI02-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI02-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI02-1 = BN then 2300.HI02-2 must begin with "E".
X223 193 2300 HI02-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI02-1 = "ABN", then 2300.HI02-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI02-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI02-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI02-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI02-9 must be valid values.
X223 193 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2:"Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 193 2300 HI03-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be valid values.
X223 193 2300 HI03-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI03-1 is "BN" then 2300.HI03-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI03-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI03-1 is "ABN" then 2300.HI03-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI03-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI03-2 must not contain a ".".
X223 193 2300 HI03-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI03-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI03-1 = BN then 2300.HI03-2 must begin with "E".
X223 193 2300 HI03-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI03-1 = "ABN", then 2300.HI03-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI03-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI03-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI03-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI03-9 must be valid values.
X223 193 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI04 can only be present if 2300.HI03 is present.
X223 193 2300 HI04-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI04-1 must be valid values.
X223 193 2300 HI04-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI04-1 is "BN" then 2300.HI04-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI04-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI04-1 is "ABN" then 2300.HI04-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI04-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI04-2 must not contain a ".".
X223 193 2300 HI04-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI04-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI04-1 = BN then 2300.HI04-2 must begin with "E".
X223 193 2300 HI04-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI04-1 = "ABN", then 2300.HI04-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI04-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI04-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI04-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI04-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI04-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI04-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI04-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI04-9 must be valid values.
X223 193 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI05 can only be present if 2300.HI04 is present.
X223 193 2300 HI05-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI05-1 must be valid values.
X223 193 2300 HI05-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI05-1 is "BN" then 2300.HI05-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI05-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI05-1 is "ABN" then 2300.HI05-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI05-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI05-2 must not contain a "."
X223 193 2300 HI05-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI05-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI05-1 = BN then 2300.HI05-2 must begin with "E".
X223 193 2300 HI05-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI05-1 = "ABN", then 2300.HI05-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI05-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI05-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI05-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI05-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI05-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI05-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI05-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI05-9 must be valid values.
X223 193 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI06 can only be present if 2300.HI05 is present.
X223 193 2300 HI06-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI06-1 must be valid values.
X223 193 2300 HI06-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI06-1 is "BN" then 2300.HI06-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI06-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI06-1 is "ABN" then 2300.HI06-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI06-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI06-2 must not contain a ".".
X223 193 2300 HI06-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI06-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI06-1 = BN then 2300.HI06-2 must begin with "E".
X223 193 2300 HI06-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI06-1 = "ABN", then 2300.HI06-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI06-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI06-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI06-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI06-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI06-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI06-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI06-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI06-9 must be valid values.
X223 193 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI07 can only be present if 2300.HI06 is present.
X223 193 2300 HI07-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI07-1 must be valid values.
X223 193 2300 HI07-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI07-1 is "BN" then 2300.HI07-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI07-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI07-1 is "ABN" then 2300.HI07-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI07-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI07-2 must not contain a ".".
X223 193 2300 HI07-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI07-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI07-1 = BN then 2300.HI07-2 must begin with "E".
X223 193 2300 HI07-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI07-1 = "ABN", then 2300.HI07-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI07-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI07-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI07-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI07-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI07-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI07-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI07-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI07-9 must be valid values.
X223 193 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI08 can only be present if 2300.HI07 is present.
X223 193 2300 HI08-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI08-1 must be valid values.
X223 193 2300 HI08-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI08-1 is "BN" then 2300.HI08-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI08-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI08-1 is "ABN" then 2300.HI08-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI08-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI08-2 must not contain a ".".
X223 193 2300 HI08-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI08-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI08-1 = BN then 2300.HI08-2 must begin with "E".
X223 193 2300 HI08-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI08-1 = "ABN", then 2300.HI08-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI08-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI08-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI08-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI08-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI08-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI08-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI08-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI08-9 must be valid values.
X223 193 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI09 can only be present if 2300.HI08 is present.
X223 193 2300 HI09-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI09-1 must be valid values.
X223 193 2300 HI09-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI09-1 is "BN" then 2300.HI09-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI09-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI09-1 is "ABN" then 2300.HI09-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI09-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI09-2 must not contain a ".".
X223 193 2300 HI09-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI09-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI09-1 = BN then 2300.HI09-2 must begin with "E".
X223 193 2300 HI09-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI09-1 = "ABN", then 2300.HI09-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI09-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI09-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI09-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI09-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI09-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI09-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI09-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI09-9 must be valid values.
X223 193 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI10 can only be present if 2300.HI09 is present.
X223 193 2300 HI10-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI10-1 must be valid values.
X223 193 2300 HI10-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI10-1 is "BN" then 2300.HI010-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI10-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI10-1 is "ABN" then 2300.HI010-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI10-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI10-2 must not contain a ".".
X223 193 2300 HI10-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI10-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI10-1 = BN then 2300.HI10-2 must begin with "E".
X223 193 2300 HI10-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI10-1 = "ABN", then 2300.HI10-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI10-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI10-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI10-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI10-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI10-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI10-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI10-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI10-9 must be valid values.
X223 193 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI11 can only be present if 2300.HI10 is present.
X223 193 2300 HI11-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI11-1 must be valid values.
X223 193 2300 HI11-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI11-1 is "BN" then 2300.HI11-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI11-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI11-1 is "ABN" then 2300.HI11-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI11-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI11-2 must not contain a ".".
X223 193 2300 HI11-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI11-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI11-1 = BN then 2300.HI11-2 must begin with "E".
X223 193 2300 HI11-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI11-1 = "ABN", then 2300.HI11-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI11-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI11-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI11-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI11-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI11-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI11-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI11-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI11-9 must be valid values.
X223 193 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI12 can only be present if 2300.HI11 is present.
X223 193 2300 HI12-1 010	Diagnosis Type Code	ID	1-3	R	N/A	ABN, BN	999	IK403 = 7: "Invalid Code Value"	2300.HI12-1 must be valid values.
X223 193 2300 HI12-2 010	External Cause of Injury Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI12-1 is "BN" then 2300.HI12-2 must be a valid ICD-9 External Cause of Injury code.
X223 193 2300 HI12-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 509: "E-Code"	If 2300.HI12-1 is "ABN" then 2300.HI12-2 must be a valid ICD-10 External Cause of Injury code.
X223 193 2300 HI12-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI12-2 must not contain a ".".
X223 193 2300 HI12-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	N/A
X223 193 2300 HI12-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI12-1 = BN then 2300.HI12-2 must begin with "E".
X223 193 2300 HI12-2 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 509: "E-Code"	If 2300.HI12-1 = "ABN", then 2300.HI12-2 must begin with a "V", "W", "X" or "Y".
X223 193 2300 HI12-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI12-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI12-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI12-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI12-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI12-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 193 2300 HI12-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI12-9 must be valid values.
X223 218 2300 HI 010	DIAGNOSIS RELATED GROUP (DRG) INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.HI with HI01-1 = "DR" is allowed.
X223 218 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 218 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	DR	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be "DR".
X223 218 2300 HI01-2 015	DRG Code	AN	1-30	R	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI01-2 must be 1-30 characters.
X223 218 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI01-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 218 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI 010	OTHER DIAGNOSIS INFORMATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2300.HI with HI01-1 = "BF" or "ABF" are allowed.
X223 220 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 220 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be valid values.
X223 220 2300 HI01-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI01-1 is "BF" then 2300.HI01-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI01-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI01-1 is "ABF" then 2300.HI01-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI01-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-2 must not contain a ".".
X223 220 2300 HI01-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI01-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI01-1 is "ABF" or "BF" the Diagnosis codes in this HI segment cannot be duplicated.
X223 220 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI01-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI01-9 must be valid values.
X223 220 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 220 2300 HI02-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be valid values.
X223 220 2300 HI02-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI02-1 is "BF" then 2300.HI02-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI02-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI02-1 is "ABF" then 2300.HI02-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI02-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI02-2 must not contain a ".".
X223 220 2300 HI02-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI02-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI02-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI02-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI02-9 must be valid values.
X223 220 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 220 2300 HI03-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be valid values.
X223 220 2300 HI03-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI03-1 is "BF" then 2300.HI03-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI03-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI03-1 is "ABF" then 2300.HI03-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI03-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI03-2 must not contain a ".".
X223 220 2300 HI03-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI03-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI03-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI03-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI03-9 must be valid values.
X223 220 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI04 can only be present if 2300.HI03 is present.
X223 220 2300 HI04-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI04-1 must be valid values.
X223 220 2300 HI04-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI04-1 is "BF" then 2300.HI04-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI04-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI04-1 is "ABF" then 2300.HI04-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI04-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI04-2 must not contain a ".".
X223 220 2300 HI04-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI04-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI04-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI04-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI04-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI04-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI04-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI04-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI04-9 must be valid values.
X223 220 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI05 can only be present if 2300.HI04 is present.
X223 220 2300 HI05-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI05-1 must be valid values.
X223 220 2300 HI05-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI05-1 is "BF" then 2300.HI05-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI05-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI05-1 is "ABF" then 2300.HI05-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI05-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI05-2 must not contain a ".".
X223 220 2300 HI05-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI05-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI05-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI05-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI05-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI05-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI05-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI05-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI05-9 must be valid values.
X223 220 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI06 can only be present if 2300.HI05 is present.
X223 220 2300 HI06-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI06-1 must be valid values.
X223 220 2300 HI06-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI06-1 is "BF" then 2300.HI06-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI06-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI06-1 is "ABF" then 2300.HI06-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI06-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI06-2 must not contain a ".".
X223 220 2300 HI06-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI06-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI06-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI06-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI06-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI06-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI06-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI06-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI06-9 must be valid values.
X223 220 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI07 can only be present if 2300.HI06 is present.
X223 220 2300 HI07-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI07-1 must be valid values.
X223 220 2300 HI07-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI07-1 is "BF" then 2300.HI01-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI07-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI07-1 is "ABF" then 2300.HI07-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI07-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI07-2 must not contain a ".".
X223 220 2300 HI07-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI07-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI07-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI07-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI07-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI07-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI07-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI07-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI07-9 must be valid values.
X223 220 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI08 can only be present if 2300.HI07 is present.
X223 220 2300 HI08-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI08-1 must be valid values.
X223 220 2300 HI08-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI08-1 is "BF" then 2300.HI08-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI08-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI08-1 is "ABF" then 2300.HI08-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI08-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI08-2 must not contain a ".".
X223 220 2300 HI08-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI08-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI08-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI08-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI08-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI08-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI08-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI08-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI08-9 must be valid values.
X223 220 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI09 can only be present if 2300.HI08 is present.
X223 220 2300 HI09-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI09-1 must be valid values.
X223 220 2300 HI09-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI09-1 is "BF" then 2300.HI09-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI09-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI09-1 is "ABF" then 2300.HI09-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI09-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI09-2 must not contain a ".."
X223 220 2300 HI09-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI09-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI09-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI09-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI09-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI09-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI09-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI09-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI09-9 must be valid values.
X223 220 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI10 can only be present if 2300.HI09 is present.
X223 220 2300 HI10-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI10-1 must be valid values.
X223 220 2300 HI10-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI10-1 is "BF" then 2300.HI10-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI10-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI10-1 is "ABF" then 2300.HI10-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI10-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI10-2 must not contain a ".".
X223 220 2300 HI10-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI10-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI10-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI10-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI10-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI10-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI10-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI10-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI10-9 must be valid values.
X223 220 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI11 can only be present if 2300.HI10 is present.
X223 220 2300 HI11-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI11-1 must be valid values.
X223 220 2300 HI11-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI11-1 is "BF" then 2300.HI11-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI11-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI11-1 is "ABF" then 2300.HI11-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI11-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI11-2 must not contain a ".".
X223 220 2300 HI11-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI11-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI11-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI11-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI11-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI11-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI11-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI11-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI11-9 must be valid values.
X223 220 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI12 can only be present if 2300.HI11 is present.
X223 220 2300 HI12-1 010	Code List Qualifier Code	ID	1-3	R	N/A	ABF, BF	999	IK403 = 7: "Invalid Code Value"	2300.HI12-1 must be valid values.
X223 220 2300 HI12-2 010	Other Diagnosis	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI12-1 is "BF" then 2300.HI12-2 must be a valid ICD-9 Diagnosis code.
X223 220 2300 HI12-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 255: "Diagnosis Code"	If 2300.HI12-1 is "ABF" then 2300.HI12-2 must be a valid ICD-10 Diagnosis code.
X223 220 2300 HI12-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI12-2 must not contain a ".".
X223 220 2300 HI12-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 255: "Diagnosis Code"	N/A
X223 220 2300 HI12-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI12-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI12-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI12-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI12-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI12-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 220 2300 HI12-9 010	Present on Admission indicator	ID	1-1	S	N/A	N, U, W, Y	999	IK403 = 7: "Invalid Code Value"	2300.HI12-9 must be valid values.
X223 239 2300 HI 050	PRINCIPAL PROCEDURE INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2300.HI with HI01-1 = "BR" or "BBR" is allowed.
X223 239 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 239 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBR, BR	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be valid values.
X223 239 2300 HI01-2 010	Principal Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 465: "Principal Procedure Code for Service(s) Rendered"	If 2300.HI01-1 is "BR" then 2300.HI01-2 must be a valid ICD-9 Procedure code.
X223 239 2300 HI01-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 465: "Principal Procedure Code for Service(s) Rendered"	If 2300.HI01-1 is "BBR" then 2300.HI01-2 must be a valid ICD-10 Procedure code.
X223 239 2300 HI01-2 025	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
X223 239 2300 HI01-2 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-2 must not contain a ".".
X223 239 2300 HI01-2 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 703: "Advanced Billing Concepts (ABC) code"	N/A
X223 239 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI01-3 must be valid values.
X223 239 2300 HI01-4 010	Date Time Period	AN	1-35	S	N/A	N/A	999	IK403 = 8: "Invalid Date"	2300.HI01-4 must be a valid date in CCYYMMDD format.
X223 239 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI01-9 010	Present on Admission indicator	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 239 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI 050	OTHER PROCEDURE INFORMATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2300.HI with HI01-1 = "BQ" "BBQ" are allowed.
X223 242 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 242 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be valid values.
X223 242 2300 HI01-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI01-1 is "BQ" then 2300.HI01-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI01-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI01-1 is "BBQ" then 2300.HI01-2 must be a valid ICD-10 Other Procedure code.
X223 242 2300 HI01-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-2 must not contain a ".".
X223 242 2300 HI01-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI01-3 must be "D8".
X223 242 2300 HI01-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI01-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI01-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 242 2300 HI02-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be valid values.
X223 242 2300 HI02-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI02-1 is "BQ" then 2300.HI02-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI02-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI02-1 is "BBQ" then 2300.HI02-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI02-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI02-2 must not contain a ".".
X223 242 2300 HI02-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI02-3 must be "D8".
X223 242 2300 HI02-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI02-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI02-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI02-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 242 2300 HI03-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be valid values.
X223 242 2300 HI03-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI03-1 is "BQ" then 2300.HI03-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI03-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI03-1 is "BBQ" then 2300.HI03-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI03-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI03-2 must not contain a ".".
X223 242 2300 HI03-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI03-3 must be "D8".
X223 242 2300 HI03-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI03-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI03-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI03-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI04 can only be present if 2300.HI03 is present.
X223 242 2300 HI04-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI04-1 must be valid values.
X223 242 2300 HI04-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI04-1 is "BQ" then 2300.HI04-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI04-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI04-1 is "BBQ" then 2300.HI04-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI04-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI04-2 must not contain a ".".
X223 242 2300 HI04-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI04-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI04-3 must be "D8".
X223 242 2300 HI04-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI04-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI04-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI04-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI04-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI04-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI04-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI05 can only be present if 2300.HI04 is present.
X223 242 2300 HI05-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI05-1 must be valid values.
X223 242 2300 HI05-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI05-1 is "BQ" then 2300.HI05-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI05-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI05-1 is "BBQ" then 2300.HI05-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI05-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI05-2 must not contain a ".".
X223 242 2300 HI05-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI05-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI05-3 must be "D8".
X223 242 2300 HI05-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI05-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI05-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI05-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI05-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI05-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI05-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI06 can only be present if 2300.HI05 is present.
X223 242 2300 HI06-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI06-1 must be valid values.
X223 242 2300 HI06-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI06-1 is "BQ" then 2300.HI06-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI06-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI06-1 is "BBQ" then 2300.HI06-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI06-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI06-2 must not contain a ".".
X223 242 2300 HI06-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI06-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI06-3 must be "D8".
X223 242 2300 HI06-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI06-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI06-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI06-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI06-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI06-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI06-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI07 can only be present if 2300.HI06 is present.
X223 242 2300 HI07-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI07-1 must be valid values.
X223 242 2300 HI07-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI07-1 is "BQ" then 2300.HI07-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI07-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI07-1 is "BBQ" then 2300.HI07-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI07-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI07-2 must not contain a ".".
X223 242 2300 HI07-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI07-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI07-3 must be "D8".
X223 242 2300 HI07-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI07-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI07-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI07-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI07-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI07-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI07-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI08 can only be present if 2300.HI07 is present.
X223 242 2300 HI08-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI08-1 must be valid values.
X223 242 2300 HI08-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI08-1 is "BQ" then 2300.HI08-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI08-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI08-1 is "BBQ" then 2300.HI08-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI08-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI08-2 must not contain a ".".
X223 242 2300 HI08-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI08-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI08-3 must be "D8".
X223 242 2300 HI08-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI08-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI08-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI08-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI08-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI08-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI08-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI09 can only be present if 2300.HI08 is present.
X223 242 2300 HI09-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI09-1 must be valid values.
X223 242 2300 HI09-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI09-1 is "BQ" then 2300.HI09-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI09-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI09-1 is "BBQ" then 2300.HI09-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI09-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI09-2 must not contain a ".".
X223 242 2300 HI09-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI09-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI09-3 must be "D8".
X223 242 2300 HI09-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI09-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI09-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI09-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI09-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI09-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI09-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI10 can only be present if 2300.HI09 is present.
X223 242 2300 HI10-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI10-1 must be valid values.
X223 242 2300 HI10-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI10-1 is "BQ" then 2300.HI10-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI10-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI10-1 is "BBQ" then 2300.HI10-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI10-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI10-2 must not contain a ".".
X223 242 2300 HI10-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI10-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI10-3 must be "D8".
X223 242 2300 HI10-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI10-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI10-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI10-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI10-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI10-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI10-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI11 can only be present if 2300.HI10 is present.
X223 242 2300 HI11-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI11-1 must be valid values.
X223 242 2300 HI11-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI11-1 is "BQ" then 2300.HI11-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI11-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI11-1 is "BBQ" then 2300.HI11-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI11-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI11-2 must not contain a ".".
X223 242 2300 HI11-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI11-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI11-3 must be "D8".
X223 242 2300 HI11-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI11-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI11-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI11-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI11-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI11-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI11-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI12 can only be present if 2300.HI11 is present.
X223 242 2300 HI12-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BBQ, BQ	999	IK403 = 7: "Invalid Code Value"	2300.HI12-1 must be valid values.
X223 242 2300 HI12-2 010	Procedure Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI12-1 is "BQ" then 2300.HI12-2 must be a valid ICD-9 Procedure code.
X223 242 2300 HI12-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 490: "Other Procedure Code for Service(s) Rendered"	If 2300.HI12-1 is "BBQ" then 2300.HI12-2 must be a valid ICD-10 Procedure code.
X223 242 2300 HI12-2 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI12-2 must not contain a ".".
X223 242 2300 HI12-2 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 511: "Invalid character" CSC 490: "Other Procedure Code for Service(s) Rendered"	N/A
X223 242 2300 HI12-3 010	Date Time Period Format Qualifier	ID	2-3	S	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI12-3 must be "D8".
X223 242 2300 HI12-4 010	Date Time Period	AN	1-35	S	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI12-4 must be a valid date in CCYYMMDD format.
X223 242 2300 HI12-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI12-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI12-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI12-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 242 2300 HI12-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI 010	OCCURRENCE SPAN INFORMATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2300.HI with HI01-1 = "BI" are allowed.
X223 258 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 258 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be "BI".
X223 258 2300 HI01-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI01-1 is "BI" then 2300.HI01-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI01-3 must be "RD8".
X223 258 2300 HI01-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI01-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI01-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 258 2300 HI02-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be "BI".
X223 258 2300 HI02-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI02-1 is "BI" then 2300.HI02-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI02-3 must be "RD8".
X223 258 2300 HI02-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI02-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI02-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI02-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 258 2300 HI03-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be "BI".
X223 258 2300 HI03-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI03-1 is "BI" then 2300.HI03-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI03-3 must be "RD8.
X223 258 2300 HI03-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI03-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI03-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI03-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI04 can only be present if 2300.HI03 is present.
X223 258 2300 HI04-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI04-1 must be "BI".
X223 258 2300 HI04-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI04-1 is "BI" then 2300.HI04-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI04-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI04-3 must be "RD8.
X223 258 2300 HI04-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI04-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI04-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI04-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI04-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI04-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI04-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI05 can only be present if 2300.HI04 is present.
X223 258 2300 HI05-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI05-1 must be "BI".
X223 258 2300 HI05-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI05-1 is "BI" then 2300.HI05-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI05-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI05-3 must be "RD8".
X223 258 2300 HI05-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI05-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI05-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI05-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI05-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI05-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI05-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI06 can only be present if 2300.HI05 is present.
X223 258 2300 HI06-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI06-1 must be "BI".
X223 258 2300 HI06-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI06-1 is "BI" then 2300.HI06-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI06-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI06-3 must be "RD8".
X223 258 2300 HI06-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI06-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI06-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI06-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI06-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI06-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI06-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI07 can only be present if 2300.HI06 is present.
X223 258 2300 HI07-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI07-1 must be "BI".
X223 258 2300 HI07-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI07-1 is "BI" then 2300.HI07-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI07-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI07-3 must be "RD8".
X223 258 2300 HI07-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI07-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI07-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI07-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI07-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI07-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI07-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI08 can only be present if 2300.HI07 is present.
X223 258 2300 HI08-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI08-1 must be "BI".
X223 258 2300 HI08-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI08-1 is "BI" then 2300.HI08-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI08-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI08-3 must be "RD8".
X223 258 2300 HI08-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI08-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI08-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI08-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI08-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI08-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI08-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI09 can only be present if 2300.HI08 is present.
X223 258 2300 HI09-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI09-1 must be "BI".
X223 258 2300 HI09-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI09-1 is "BI" then 2300.HI09-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI09-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI09-3 must be "RD8".
X223 258 2300 HI09-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI09-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI09-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI09-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI09-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI09-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI09-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI10 can only be present if 2300.HI09 is present.
X223 258 2300 HI10-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI10-1 must be "BI".
X223 258 2300 HI10-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI10-1 is "BI" then 2300.HI10-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI10-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI10-3 must be "RD8".
X223 258 2300 HI10-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI10-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI10-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI10-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI10-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI10-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI10-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI11 can only be present if 2300.HI10 is present.
X223 258 2300 HI11-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI11-1 must be "BI".
X223 258 2300 HI11-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI11-1 is "BI" then 2300.HI11-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI11-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI11-3 must be "RD8".
X223 258 2300 HI11-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI11-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI11-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI11-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI11-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI11-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI11-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI12 can only be present if 2300.HI11 is present.
X223 258 2300 HI12-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BI	999	IK403 = 7: "Invalid Code Value"	2300.HI12-1 must be "BI".
X223 258 2300 HI12-2 010	Occurrence Span Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 721: "NUBC Occurrence Span Code(s)"	If 2300.HI12-1 is "BI" then 2300.HI12-2 must be a valid Occurrence Span code on the receipt date and is within the codes effective and termination date.
X223 258 2300 HI12-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	RD8	999	IK403 = 7: "Invalid Code Value"	2300.HI12-3 must be "RD8".
X223 258 2300 HI12-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD-CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI12-4 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 258 2300 HI12-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI12-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI12-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI12-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 258 2300 HI12-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI 010	OCCURRENCE INFORMATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2300.HI with HI01-1 = "BH" are allowed.
X223 271 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 271 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be "BH".
X223 271 2300 HI01-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI01-1 is "BH" then 2300.HI01-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI01-3 must be "D8".
X223 271 2300 HI01-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI01-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI01-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 271 2300 HI02-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be "BH".
X223 271 2300 HI02-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI02-1 is "BH" then 2300.HI02-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI02-3 must be "D8".
X223 271 2300 HI02-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI02-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI02-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI02-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 271 2300 HI03-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be "BH".
X223 271 2300 HI03-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI03-1 is "BH" then 2300.HI03-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI03-3 must be "D8".
X223 271 2300 HI03-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI03-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI03-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI03-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI04 can only be present if 2300.HI03 is present.
X223 271 2300 HI04-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI04-1 must be "BH".
X223 271 2300 HI04-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI04-1 is "BH" then 2300.HI04-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI04-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI04-3 must be "D8".
X223 271 2300 HI04-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI04-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI04-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI04-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI04-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI04-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI04-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI05 can only be present if 2300.HI04 is present.
X223 271 2300 HI05-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI05-1 must be "BH".
X223 271 2300 HI05-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI05-1 is "BH" then 2300.HI05-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI05-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI05-3 must be "D8".
X223 271 2300 HI05-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI05-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI05-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI05-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI05-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI05-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI05-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI06 can only be present if 2300.HI05 is present.
X223 271 2300 HI06-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI06-1 must be "BH".
X223 271 2300 HI06-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI06-1 is "BH" then 2300.HI06-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI06-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI06-3 must be "D8".
X223 271 2300 HI06-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI06-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI06-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI06-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI06-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI06-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI06-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI07 can only be present if 2300.HI06 is present.
X223 271 2300 HI07-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI07-1 must be "BH".
X223 271 2300 HI07-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI07-1 is "BH" then 2300.HI07-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI07-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI07-3 must be "D8".
X223 271 2300 HI07-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI07-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI07-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI07-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI07-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI07-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI07-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI08 can only be present if 2300.HI07 is present.
X223 271 2300 HI08-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI08-1 must be "BH".
X223 271 2300 HI08-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI08-1 is "BH" then 2300.HI08-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI08-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI08-3 must be "D8".
X223 271 2300 HI08-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI08-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI08-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI08-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI08-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI08-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI08-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI09 can only be present if 2300.HI08 is present.
X223 271 2300 HI09-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI09-1 must be "BH".
X223 271 2300 HI09-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI09-1 is "BH" then 2300.HI09-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI09-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI09-3 must be "D8".
X223 271 2300 HI09-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI09-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI09-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI09-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI09-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI09-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI09-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI10 can only be present if 2300.HI09 is present.
X223 271 2300 HI10-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI10-1 must be "BH".
X223 271 2300 HI10-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI10-1 is "BH" then 2300.HI10-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI10-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI10-3 must be "D8".
X223 271 2300 HI10-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI10-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI10-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI10-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI10-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI10-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI10-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI11 can only be present if 2300.HI10 is present.
X223 271 2300 HI11-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI11-1 must be "BH".
X223 271 2300 HI11-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI11-1 is "BH" then 2300.HI11-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI11-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI11-3 must be "D8".
X223 271 2300 HI11-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI11-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI11-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI11-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI11-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI11-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI11-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI12 can only be present if 2300.HI11 is present.
X223 271 2300 HI12-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BH	999	IK403 = 7: "Invalid Code Value"	2300.HI12-1 must be "BH".
X223 271 2300 HI12-2 010	Occurrence Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 719: "NUBC Occurrence Code(s)"	If 2300.HI12-1 is "BH" then 2300.HI12-2 must be a valid Occurrence code on the receipt date and is within the codes effective and termination date.
X223 271 2300 HI12-3 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 7: "Invalid Code Value"	2300.HI12-3 must be "D8".
X223 271 2300 HI12-4 010	Date Time Period	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2300.HI12-4 must be a valid date in CCYYMMDD format.
X223 271 2300 HI12-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI12-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI12-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI12-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 271 2300 HI12-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI 010	VALUE INFORMATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2300.HI with HI01-1 = "BE" are allowed.
X223 284 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 284 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be "BE".
X223 284 2300 HI01-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI01-1 is "BE" then 2300.HI01-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI01-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-5 must be numeric.
X223 284 2300 HI01-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI01-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI01-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI01-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 284 2300 HI02-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be "BE".
X223 284 2300 HI02-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI02-1 is "BE" then 2300.HI02-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI02-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI02-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI02-5 must be numeric.
X223 284 2300 HI02-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI02-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI02-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI02-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 284 2300 HI03-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be "BE".
X223 284 2300 HI03-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI03-1 is "BE" then 2300.HI03-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI03-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI03-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI03-5 must be numeric.
X223 284 2300 HI03-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI03-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI03-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI03-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI04 can only be present if 2300.HI03 is present.
X223 284 2300 HI04-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI04-1 must be "BE".
X223 284 2300 HI04-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI04-1 is "BE" then 2300.HI04-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI04-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI04-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI04-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI04-5 must be numeric.
X223 284 2300 HI04-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI04-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI04-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI04-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI04-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI04-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI04-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI05 can only be present if 2300.HI04 is present.
X223 284 2300 HI05-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI05-1 must be "BE".
X223 284 2300 HI05-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI05-1 is "BE" then 2300.HI05-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI05-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI05-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI05-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI05-5 must be numeric.
X223 284 2300 HI05-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI05-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI05-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI05-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI05-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI05-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI05-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI06 can only be present if 2300.HI05 is present.
X223 284 2300 HI06-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI06-1 must be "BE".
X223 284 2300 HI06-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI06-1 is "BE" then 2300.HI06-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI06-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI06-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI06-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI06-5 must be numeric.
X223 284 2300 HI06-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI06-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI06-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI06-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI06-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI06-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI06-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI07 can only be present if 2300.HI06 is present.
X223 284 2300 HI07-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI07-1 must be "BE".
X223 284 2300 HI07-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI07-1 is "BE" then 2300.HI07-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI07-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI07-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI07-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI07-5 must be numeric.
X223 284 2300 HI07-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI07-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI07-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI07-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI07-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI07-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI07-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI08 can only be present if 2300.HI07 is present.
X223 284 2300 HI08-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI08-1 must be "BE".
X223 284 2300 HI08-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI08-1 is "BE" then 2300.HI08-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI08-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI08-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI08-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI08-5 must be numeric.
X223 284 2300 HI08-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI08-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI08-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI08-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI08-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI08-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI08-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI09 can only be present if 2300.HI08 is present.
X223 284 2300 HI09-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI09-1 must be "BE".
X223 284 2300 HI09-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI09-1 is "BE" then 2300.HI09-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI09-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI09-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI09-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI09-5 must be numeric.
X223 284 2300 HI09-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI09-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI09-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI09-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI09-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI09-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI09-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI10 can only be present if 2300.HI09 is present.
X223 284 2300 HI10-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI10-1 must be "BE".
X223 284 2300 HI10-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI10-1 is "BE" then 2300.HI10-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI10-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI10-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI10-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI10-5 must be numeric.
X223 284 2300 HI10-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.H110-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI10-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI10-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI10-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI10-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI10-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI11 can only be present if 2300.HI10 is present.
X223 284 2300 HI11-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI11-1 must be "BE".
X223 284 2300 HI11-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI11-1 is "BE" then 2300.HI11-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI11-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI11-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI11-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI11-5 must be numeric.
X223 284 2300 HI11-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI11-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI11-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI11-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI11-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI11-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI11-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI12 can only be present if 2300.HI11 is present.
X223 284 2300 HI12-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BE	999	IK403 = 7: "Invalid Code Value"	2300.HI12-1 must be "BE".
X223 284 2300 HI12-2 010	Value Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 725: "NUBC Value Code(s)"	If 2300.HI12-1 is "BE" then 2300.HI12-2 must be a valid Value code on the receipt date and is within the codes effective and termination date.
X223 284 2300 HI12-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI12-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI12-5 010	Value Code Associated Amount	R	1-18	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI12-5 must be numeric.
X223 284 2300 HI12-5 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI12-5 must be >= 0 and <= 99,999,999.99.
X223 284 2300 HI12-5 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 726: "NUBC Value Code Amount(s)"	N/A
X223 284 2300 HI12-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI12-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI12-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 284 2300 HI12-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI 010	CONDITION INFORMATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2300.HI with HI01-1 = "BG" are allowed.
X223 294 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 294 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be "BG".
X223 294 2300 HI01-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI01-1 is "BG" then 2300.HI01-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI01-2 020	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI01-1 is "BG" the Condition codes within this HI segment cannot be duplicated.
X223 294 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI01-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 294 2300 HI02-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be "BG".
X223 294 2300 HI02-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI02-1 is "BG" then 2300.HI02-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI02-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI02-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI02-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 294 2300 HI03-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be "BG".
X223 294 2300 HI03-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI03-1 is "BG" then 2300.HI03-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI03-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI03-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI03-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI04 can only be present if 2300.HI03 is present.
X223 294 2300 HI04-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI04-1 must be "BG".
X223 294 2300 HI04-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI04-1 is "BG" then 2300.HI04-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI04-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI04-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI04-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI04-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI04-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI04-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI04-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI05 can only be present if 2300.HI04 is present.
X223 294 2300 HI05-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI05-1 must be "BG".
X223 294 2300 HI05-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI05-1 is "BG" then 2300.HI05-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI05-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI05-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI05-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI05-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI05-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI05-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI05-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI06 can only be present if 2300.HI05 is present.
X223 294 2300 HI06-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI06-1 must be "BG".
X223 294 2300 HI06-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI06-1 is "BG" then 2300.HI06-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI06-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI06-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI06-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI06-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI06-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI06-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI06-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI07 can only be present if 2300.HI06 is present.
X223 294 2300 HI07-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI07-1 must be "BG".
X223 294 2300 HI07-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI07-1 is "BG" then 2300.HI07-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI07-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI07-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI07-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI07-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI07-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI07-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI07-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI08 can only be present if 2300.HI07 is present.
X223 294 2300 HI08-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI08-1 must be "BG".
X223 294 2300 HI08-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI08-1 is "BG" then 2300.HI08-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI08-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI08-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI08-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI08-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI08-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI08-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI08-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI09 can only be present if 2300.HI08 is present.
X223 294 2300 HI09-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI09-1 must be "BG".
X223 294 2300 HI09-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI09-1 is "BG" then 2300.HI09-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI09-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI09-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI09-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI09-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI09-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI09-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI09-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI10 can only be present if 2300.HI09 is present.
X223 294 2300 HI10-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI10-1 must be "BG".
X223 294 2300 HI10-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI10-1 is "BG" then 2300.HI10-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI10-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI10-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI10-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI10-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI10-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI10-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI10-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI11 can only be present if 2300.HI10 is present.
X223 294 2300 HI11-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI11-1 must be "BG".
X223 294 2300 HI11-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI11-1 is "BG" then 2300.HI11-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI11-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI11-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI11-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI11-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI11-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI11-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI11-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI12 can only be present if 2300.HI11 is present.
X223 294 2300 HI12-1 010	Code List Qualifier Code	ID	1-3	R	N/A	BG	999	IK403 = 7: "Invalid Code Value"	2300.HI12-1 must be "BG".
X223 294 2300 HI12-2 010	Condition Code	AN	1-30	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 460: "NUBC Condition Code(s)"	If 2300.HI12-1 is "BG" then 2300.HI12-2 must be a valid Condition code on the receipt date and is within the codes effective and termination date.
X223 294 2300 HI12-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI12-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI12-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI12-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI12-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI12-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 294 2300 HI12-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI 030	TREATMENT CODE INFORMATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2300.HI with HI01-1 = "TC" are allowed.
X223 304 2300 HI01 010	HEALTH CARE CODE INFORMATION	N/A	N/A	R	N/A	N/A	N/A	N/A	N/A
X223 304 2300 HI01-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI01-1 must be "TC".
X223 304 2300 HI01-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI01-2 must contain at least one non-space character.
X223 304 2300 HI01-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI01-2 must be 1-30 characters.
X223 304 2300 HI01-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI01-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI01-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI01-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI01-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI01-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI01-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI02 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI02 can only be present if 2300.HI01 is present.
X223 304 2300 HI02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 658: "Treatment Code"	The treatment codes in this HI segment cannot be duplicated.
X223 304 2300 HI02-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI02-1 must be "TC".
X223 304 2300 HI02-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI02-2 must contain at least one non-space character.
X223 304 2300 HI02-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI02-2 must be 1-30 characters.
X223 304 2300 HI02-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI02-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI02-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI02-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI02-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI02-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI02-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI03 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI03 can only be present if 2300.HI02 is present.
X223 304 2300 HI03-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI03-1 must be "TC".
X223 304 2300 HI03-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI03-2 must contain at least one non-space character.
X223 304 2300 HI03-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI03-2 must be 1-30 characters.
X223 304 2300 HI03-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI03-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI03-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI03-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI03-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI03-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI03-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI04 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI04 can only be present if 2300.HI03 is present.
X223 304 2300 HI04-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI04-1 must be "TC".
X223 304 2300 HI04-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI04-2 must contain at least one non-space character.
X223 304 2300 HI04-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI04-2 must be 1-30 characters.
X223 304 2300 HI04-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI04-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI04-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI04-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI04-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI04-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI04-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI05 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI05 can only be present if 2300.HI04 is present.
X223 304 2300 HI05-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI05-1 must be "TC".
X223 304 2300 HI05-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI05-2 must contain at least one non-space character.
X223 304 2300 HI05-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI05-2 must be 1-30 characters.
X223 304 2300 HI05-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI05-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI05-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI05-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI05-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI05-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI05-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI06 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI06 can only be present if 2300.HI05 is present.
X223 304 2300 HI06-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI06-1 must be "TC".
X223 304 2300 HI06-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI06-2 must contain at least one non-space character.
X223 304 2300 HI06-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI06-2 must be 1-30 characters.
X223 304 2300 HI06-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI06-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI06-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI06-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI06-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI06-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI06-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI07 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI07 can only be present if 2300.HI06 is present.
X223 304 2300 HI07-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI07-1 must be "TC".
X223 304 2300 HI07-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI07-2 must contain at least one non-space character.
X223 304 2300 HI07-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI07-2 must be 1-30 characters.
X223 304 2300 HI07-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI07-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI07-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI07-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI07-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI07-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI07-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI08 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI08 can only be present if 2300.HI07 is present.
X223 304 2300 HI08-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI08-1 must be "TC".
X223 304 2300 HI08-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI08-2 must contain at least one non-space character.
X223 304 2300 HI08-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI08-2 must be 1-30 characters.
X223 304 2300 HI08-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI08-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI08-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI08-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI08-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI08-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI08-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI09 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI09 can only be present if 2300.HI08 is present.
X223 304 2300 HI09-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI09-1 must be "TC".
X223 304 2300 HI09-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI09-2 must contain at least one non-space character.
X223 304 2300 HI09-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI09-2 must be 1-30 characters.
X223 304 2300 HI09-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI09-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI09-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI09-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI09-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI09-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI09-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI10 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI10 can only be present if 2300.HI09 is present.
X223 304 2300 HI10-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI10-1 must be "TC".
X223 304 2300 HI10-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI10-2 must contain at least one non-space character.
X223 304 2300 HI10-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI10-2 must be 1-30 characters.
X223 304 2300 HI10-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI10-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI10-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI10-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI10-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI10-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI10-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI11 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI11 can only be present if 2300.HI10 is present.
X223 304 2300 HI11-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI11-1 must be "TC".
X223 304 2300 HI11-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI11-2 must contain at least one non-space character.
X223 304 2300 HI11-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI11-2 must be 1-30 characters.
X223 304 2300 HI11-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI11-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI11-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI11-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI11-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI11-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI11-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI12 010	HEALTH CARE CODE INFORMATION	N/A	N/A	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2300.HI12 can only be present if 2300.HI11 is present.
X223 304 2300 HI12-1 010	Code List Qualifier Code	ID	1-3	R	N/A	TC	999	IK403 = 7: "Invalid Code Value"	2300.HI12-1 must be "TC".
X223 304 2300 HI12-2 010	Treatment Code	AN	1-30	R	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.HI12-2 must contain at least one non-space character.
X223 304 2300 HI12-2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300.HI12-2 must be 1-30 characters.
X223 304 2300 HI12-3 010	Date Time Period Format Qualifier	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI12-4 010	Date Time Period	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI12-5 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI12-6 010	Quantity	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI12-7 010	Version Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI12-8 010	Industry code	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 304 2300 HI12-9 010	Yes/No Condition or response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 313 2300 HCP 015	CLAIM PRICING/REPRICING INFORMATION	N/A	1	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 64: "Re-pricing information."	Segment must not be present.
X223 319 2310A NM1 010	ATTENDING PROVIDER NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	If present, only one iteration of 2310A.NM1 is allowed.
X223 319 2310A NM101 010	Entity Identifier Code	ID	2-3	R	N/A	71	999	IK304 = 2: "Unexpected segment"	2310A.NM101 must be present and a valid value.
X223 319 2310A NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2310A.NM102 must be present.
X223 319 2310A NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310A.NM102 must be "1".
X223 319 2310A NM103 010	Name Last	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310A.NM103 must be present.
X223 319 2310A NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310A.NM103 must contain at least one non-space character.
X223 319 2310A NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310A.NM103 must be 1 - 60 characters.
X223 319 2310A NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: 71 "Attending Physician"	N/A
X223 319 2310A NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310A.NM103 must be populated with accepted AN characters.
X223 319 2310A NM104 010	Name First	AN	1-35	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310A.NM104 must be 1 - 35 characters.
X223 319 2310A NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: 71 "Attending Physician"	N/A
X223 319 2310A NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310A.NM104 must be populated with accepted AN characters.
X223 319 2310A NM105 010	Name Middle	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310A.NM105 must contain at least one non-space character.
X223 319 2310A NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310A.NM105 must be 1 - 25 characters.
X223 319 2310A NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: 71 "Attending Physician"	N/A
X223 319 2310A NM105 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310A.NM105 must be populated with accepted AN characters.
X223 319 2310A NM105 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: 71 "Attending Physician"	The first position of 2310A.NM105 must be alphabetic (A...Z).
X223 319 2310A NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 319 2310A NM107 005	Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310A.NM107 must contain at least one non-space character.
X223 319 2310A NM107 010	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310A.NM107 must be 1 - 10 characters.
X223 319 2310A NM107 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: 71 "Attending Physician"	N/A
X223 319 2310A NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310A.NM107 must be populated with accepted AN characters.
X223 319 2310A NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 71 "Attending Physician"	2310A.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 319 2310A NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 71 "Attending Physician"	2310A.NM108 must be present.
X223 319 2310A NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310A.NM108 must be "XX".
X223 319 2310A NM109 005	Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2310A.NM109 must be present if 2310A.NM108 is present.
X223 319 2310A NM109 010	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 71 "Attending Physician"	2310A.NM109 must be valid according to the NPI algorithm.
X223 319 2310A NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 71 "Attending Physician"	The first position of 2310A.NM109 must be a "1".
X223 319 2310A NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 319 2310A NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 319 2310A NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 322 2310A PRV 020	ATTENDING PROVIDER SPECIALTY INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2310A.PRV is allowed.
X223 322 2310A PRV01 010	Provider Code	ID	1-3	R	N/A	AT	999	IK403 = 1: "Required Data Element Missing"	2310A .PRV01 must be present.
X223 322 2310A PRV01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310A .PRV01 must be "AT".
X223 322 2310A PRV02 010	Reference Identification Qualifier	ID	2-3	R	N/A	PXC	999	IK403 = 1: "Required Data Element Missing"	2310A .PRV02 must be present.
X223 322 2310A PRV02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310A .PRV02 must be "PXC".
X223 322 2310A PRV03 010	Provider Taxonomy Code	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310A .PRV03 must be present.
X223 322 2310A PRV03 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 145: "Entity's specialty/taxonomy code" EIC: 71 "Attending Physician"	2310A .PRV03 must be a valid Provider Taxonomy Code.
X223 322 2310A PRV04 010	State or Province Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 322 2310A PRV05 010	PROVIDER SPECIALTY INFORMATION	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 322 2310A PRV06 010	Provider Organization Code	ID	3-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 324 2310A REF 010	ATTENDING PROVIDER SECONDARY IDENTIFICATION	N/A	4	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2310A.NM109 is not present, 2310A.REF with REF01 = "1G" must be present.
X223 324 2310A REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 71 "Attending Physician"	Only 1 iteration of 2310A.REF with REF01 = "1G" is allowed.
X223 324 2310A REF 035	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2310A.REF must be present if 2300.REF01 = P4 and 2300.REF02 = is a valid VA qualifier.
X223 324 2310A REF 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2310A.REF must not be present.
X223 324 2310A REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	0B, 1G, G2, LU	999	IK403 = 1: "Required Data Element Missing"	2310A .REF01 must be present.
X223 324 2310A REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 21: Missing or invalid information CSC 560: Entity's Additional/Secondary Identifier EIC: 71 "Attending Physician"	2310A.REF01 must be "1G".
X223 324 2310A REF02 010	Attending Provider Secondary Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310A .REF02 must be present.
X223 324 2310A REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" EIC: 71 "Attending Physician"	2310A.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 324 2310A REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 324 2310A REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 326 2310B NM1 010	OPERATING PHYSICIAN NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2310B.NM1 is allowed.
X223 326 2310B NM101 010	Entity Identifier Code	ID	2-3	R	N/A	72	999	IK304 = 2: "Unexpected segment"	2310B.NM101 must be present and a valid value.
X223 326 2310B NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2310B.NM102 must be present.
X223 326 2310B NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310B.NM102 must be "1".
X223 326 2310B NM103 010	Last or Organization Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310B.NM103 must be present.
X223 326 2310B NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310B.NM103 must contain at least one non-space character.
X223 326 2310B NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310B.NM103 must be 1 - 60 characters.
X223 326 2310B NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: 72 "Operating Physician"	N/A
X223 326 2310B NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310B.NM103 must be populated with accepted AN characters.
X223 326 2310B NM104 010	Name First	AN	1-35	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310B.NM104 must contain at least one non-space character.
X223 326 2310B NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310B.NM104 must be 1 - 35 characters.
X223 326 2310B NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: 72 "Operating Physician"	N/A
X223 326 2310B NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310B.NM104 must be populated with accepted AN characters.
X223 326 2310B NM105 010	Middle Name	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310B.NM105 must contain at least one non-space character.
X223 326 2310B NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310B.NM105 must be 1 - 25 characters.
X223 326 2310B NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: 72 "Operating Physician"	N/A
X223 326 2310B NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310B.NM105 must be populated with accepted AN characters.
X223 326 2310B NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: 72 "Operating Physician"	The first position of 2310B.NM105 must be alphabetic (A...Z).
X223 326 2310B NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 326 2310B NM107 010	Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310B.NM107 must contain at least one non-space character.
X223 326 2310B NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310B.NM107 must be 1 - 10 characters.
X223 326 2310B NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: 72 "Operating Physician"	N/A
X223 326 2310B NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310B.NM107 must be populated with accepted AN characters.
X223 326 2310B NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2310B.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 326 2310B NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2310B.NM108 must be present.
X223 326 2310B NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310B.NM108 must be "XX".
X223 326 2310B NM109 010	Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2310B.NM109 must be present if 2310B.NM108 is present.
X223 326 2310B NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2310B.NM109 must be valid according to the NPI algorithm.
X223 326 2310B NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	The first position of 2310B.NM109 must be a "1".
X223 326 2310B NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 326 2310B NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 326 2310B NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 329 2310B REF 010	OPERATING PHYSICIAN SECONDARY IDENTIFICATION	N/A	4	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2310B.NM109 is not present, 2310B.REF with REF01 = "1G" must be present.
X223 329 2310B REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: Entity's Additional/Secondary Identifier EIC: 72 "Operating Physician"	Only 1 iteration of 2310B.REF with REF01 = "1G" is allowed.
X223 329 2310B REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2310B.REF must not be present.
X223 329 2310B REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	0B, 1G, G2, LU	999	IK403 = 1: "Required Data Element Missing"	2310B.REF01 must be present.
X223 329 2310B REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 21: Missing or invalid information CSC 560: Entity's Additional/Secondary Identifier EIC: 72 "Operating Physician"	2310B.REF01 must be "1G".
X223 329 2310B REF02 010	Secondary Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310B.REF02 must be present.
X223 329 2310B REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" EIC: 72 "Operating Physician"	2310B.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 329 2310B REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 329 2310B REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 331 2310C NM1 010	OTHER OPERATING PHYSICIAN NAME	N/A	1	S	1	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2310C.NM1 is present 2310B.NM1 must be present.
X223 331 2310C NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2310C.NM1 is allowed.
X223 331 2310C NM101 010	Entity Identifier Code	ID	2-3	R	N/A	ZZ	999	IK304 = 2: "Unexpected segment"	2310C.NM101 must be present.
X223 331 2310C NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2310C.NM102 must be present.
X223 331 2310C NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310C.NM102 must be "1".
X223 331 2310C NM103 010	Other Operating Physician Last Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310C.NM103 must be present.
X223 331 2310C NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310C.NM103 must contain at least one non-space character.
X223 331 2310C NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310C.NM103 must be 1 - 60 characters.
X223 331 2310C NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: 72 "Operating Physician"	N/A
X223 331 2310C NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310C.NM103 must be populated with accepted AN characters.
X223 331 2310C NM104 010	Other Operating Physician First Name	AN	1-35	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310C.NM104 must contain at least one non-space character.
X223 331 2310C NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310C.NM104 must be 1 - 35 characters.
X223 331 2310C NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: 72 "Operating Physician"	N/A
X223 331 2310C NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310C.NM104 must be populated with accepted AN characters.
X223 331 2310C NM105 010	Other Operating Physician Middle Name or Initial	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310C.NM105 must contain at least one non-space character.
X223 331 2310C NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310C.NM105 must be 1 - 25 characters.
X223 331 2310C NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: 72 "Operating Physician"	N/A
X223 331 2310C NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310C.NM105 must be populated with accepted AN characters.
X223 331 2310C NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: 72 "Operating Physician"	The first position of 2310C.NM105 must be alphabetic (A...Z).
X223 331 2310C NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 331 2310C NM107 010	Other Operating Physician Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310C.NM107 must contain at least one non-space character.
X223 331 2310C NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310C.NM107 must be 1 - 10 characters.
X223 331 2310C NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: 72 "Operating Physician"	N/A
X223 331 2310C NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310C.NM107 must be populated with accepted AN characters.
X223 331 2310C NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2310C.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 331 2310C NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2310C.NM108 must be present.
X223 331 2310C NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310C.NM108 must be "XX".
X223 331 2310C NM109 010	Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2310C.NM109 must be present if 2310C.NM108 is present.
X223 331 2310C NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2310C.NM109 must be valid according to the NPI algorithm.
X223 331 2310C NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	The first position of 2310C.NM109 must be a "1".
X223 331 2310C NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 331 2310C NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 331 2310C NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 334 2310C REF 010	OTHER OPERATING PHYSICIAN SECONDARY IDENTIFICATION	N/A	4	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2310C.NM109 is not present, 2310C.REF with REF01 = "1G" must be present.
X223 334 2310C REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 72 "Operating Physician"	Only 1 iteration of 2310C.REF with REF01 = "1G" is allowed.
X223 334 2310C REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2310C.REF must not be present.
X223 334 2310C REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	0B, 1G, G2, LU	999	IK403 = 1: "Required Data Element Missing"	2310C.REF01 must be present.
X223 334 2310C REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 21: Missing or invalid information CSC 560: Entity's Additional/Secondary Identifier EIC: 72 "Operating Physician"	2310C.REF01 must be "1G".
X223 334 2310C REF02 010	Secondary Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310C.REF02 must be present.
X223 334 2310C REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" EIC: 72 "Operating Physician"	2310C.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 334 2310C REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 334 2310C REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 336 2310D NM1 010	RENDERING PROVIDER NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2310D.NM1 is allowed.
X223 336 2310D NM101 010	Entity Identifier Code	ID	2-3	R	N/A	82	999	IK304 = 2: "Unexpected segment"	2310D.NM101 must be present and a valid value.
X223 336 2310D NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2310D.NM102 must be present.
X223 336 2310D NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310D.NM102 must be "1".
X223 336 2310D NM103 010	Rendering Provider Last Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310D.NM103 must be present.
X223 336 2310D NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310D.NM103 must contain at least one non-space character.
X223 336 2310D NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310D.NM103 must be 1 - 60 characters.
X223 336 2310D NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: 82 "Rendering Provider"	N/A
X223 336 2310D NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310D.NM103 must be populated with accepted AN characters.
X223 336 2310D NM104 010	Rendering Provider First Name	AN	1-35	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310D.NM104 must contain at least one non-space character.
X223 336 2310D NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310D.NM104 must be 1 - 35 characters.
X223 336 2310D NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: 82 "Rendering Provider"	N/A
X223 336 2310D NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310D.NM104 must be populated with accepted AN characters.
X223 336 2310D NM105 010	Rendering Provider Middle Name or Initial	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310D.NM105 must contain at least one non-space character.
X223 336 2310D NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310D.NM105 must be 1 - 25 characters.
X223 336 2310D NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: 82 "Rendering Provider"	N/A
X223 336 2310D NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310D.NM105 must be populated with accepted AN characters.
X223 336 2310D NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: 82 "Rendering Provider"	The first position of 2310D.NM105 must be alphabetic (A...Z).
X223 336 2310D NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 336 2310D NM107 010	Rendering Provider Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310D.NM107 must contain at least one non-space character.
X223 336 2310D NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310D.NM107 must be 1 - 10 characters.
X223 336 2310D NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: 82 "Rendering Provider"	N/A
X223 336 2310D NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310D.NM107 must be populated with accepted AN characters.
X223 336 2310D NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 82 "Rendering Provider"	2310D.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 336 2310D NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 82 "Rendering Provider"	2310D.NM108 must be present.
X223 336 2310D NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310D.NM108 must be "XX".
X223 336 2310D NM109 010	Rendering Provider Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2310D.NM109 must be present if 2310D.NM108 is present.
X223 336 2310D NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 82 "Rendering Provider"	2310D.NM109 must be valid according to the NPI algorithm.
X223 336 2310D NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 82 "Rendering Provider"	The first position of 2310D.NM109 must be a "1".
X223 336 2310D NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 336 2310D NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 336 2310D NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 339 2310D REF 010	RENDERING PROVIDER SECONDARY IDENTIFICATION	N/A	4	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2310D.NM109 is not present, 2310D.REF with REF01 = "1G" must be present.
X223 339 2310D REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 82 "Rendering Provider"	Only 1 iteration of 2310D.REF with REF01 = "1G" is allowed.
X223 339 2310D REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2310D.REF must not be present.
X223 339 2310D REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	0B, 1G, G2, LU	999	IK403 = 1: "Required Data Element Missing"	2310D.REF01 must be present.
X223 339 2310D REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 82 "Rendering Provider"	2310D.REF01 must be "1G".
X223 339 2310D REF02 010	Rendering Provider Secondary Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310D.REF02 must be present.
X223 339 2310D REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" EIC: 82 "Rendering Provider"	2310D.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 339 2310D REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 339 2310D REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 341 2310E NM1 010	SERVICE FACILITY LOCATION NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2310E.NM1 is allowed.
X223 341 2310E NM101 010	Entity Identifier Code	ID	2-3	R	N/A	77	999	IK304 = 2: "Unexpected segment"	2310E.NM101 must be present and a valid value.
X223 341 2310E NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	2	999	IK403 = 1: "Required Data Element Missing"	2310E.NM102 must be present.
X223 341 2310E NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310E.NM102 must be "2".
X223 341 2310E NM103 010	Laboratory or Facility Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310E.NM103 must be present.
X223 341 2310E NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310E.NM103 must contain at least one non-space character.
X223 341 2310E NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310E.NM103 must be 1 - 60 characters.
X223 341 2310E NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125 "Entity's name." EIC: 77 "Service Location"	N/A
X223 341 2310E NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310E.NM103 must be populated with accepted AN characters.
X223 341 2310E NM104 010	Name First	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 341 2310E NM105 010	Name Middle	AN	1-25	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 341 2310E NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 341 2310E NM107 010	Name Suffix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 341 2310E NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	999	IK403 = 7: "Invalid Code Value"	2310E.NM108 must be "XX".
X223 341 2310E NM109 010	Laboratory or Facility Primary Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2310E.NM109 must be present if 2310E.NM108 is present.
X223 341 2310E NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 77 "Service Location"	2310E.NM109 must be valid according to the NPI algorithm.
X223 341 2310E NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 77 "Service Location"	The first position of 2310E.NM109 must be a "1".
X223 341 2310E NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 341 2310E NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 341 2310E NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 344 2310E N3 010	SERVICE FACILITY LOCATION ADDRESS	N/A	1	R	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2310E.NM1 is present, 2310.N3 must be present.
X223 344 2310E N3 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2310E.N3 is allowed.
X223 344 2310E N301 010	Laboratory or Facility Address Line	AN	1-55	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310E.N301 must be present.
X223 344 2310E N301 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310E.N301 must contain at least one non-space character.
X223 344 2310E N301 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310E.N301 must be 1-55 characters.
X223 344 2310E N301 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street address" EIC: 77 "Service Location"	N/A
X223 344 2310E N301 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310E.N301 must be populated with accepted AN characters.
X223 344 2310E N302 020	Laboratory or Facility Address Line	AN	1-55	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If present, 2310E.N302 must contain at least one non-space character.
X223 344 2310E N302 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310E.N302 must be 1-55 characters.
X223 344 2310E N302 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street address" EIC: 77 "Service Location"	N/A
X223 344 2310E N302 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310E.N302 must be populated with accepted AN characters.
X223 345 2310E N4 010	SERVICE FACILITY LOCATION CITY, STATE, ZIP CODE	N/A	1	R	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2310E.N3 is present, 2301E.N4 must be present.
X223 345 2310E N4 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2310E.N4 is allowed.
X223 345 2310E N401 010	Laboratory or Facility City Name	AN	2-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310E.N401 must be present.
X223 345 2310E N401 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310E.N401 must contain at least two non-space characters.
X223 345 2310E N401 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2310E.N401 must be 2-30 characters.
X223 345 2310E N401 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 502: "Entity's City" EIC: 77 "Service Location"	N/A
X223 345 2310E N401 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310E.N401 must be populated with accepted AN characters.
X223 345 2310E N402 010	Laboratory or Facility State or Province Code	ID	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2310E.N404 is not present, 2310E.N402 must be present.
X223 345 2310E N402 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 501: "Entity's State/Province" EIC: 77 "Service Location"	2310E.N402 must be a valid state code.
X223 345 2310E N403 010	Laboratory or Facility Postal Zone or ZIP Code	ID	3-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2310E.N404 is not present, 2310E.N403 must be present.
X223 345 2310E N403 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 500: "Entity's Postal/Zip Code" EIC: 77 "Service Location"	2310E.N403 must be a valid 9 digit zip code.
X223 345 2310E N404 010	Country Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 345 2310E N405 010	Location Qualifier	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 345 2310E N406 010	Location Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 345 2310E N407 010	Country Subdivision Code	ID	1-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 347 2310E REF 010	SERVICE FACILITY LOCATION SECONDARY IDENTIFICATION	N/A	5	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 77 "Service Location"	2310E.REF must not be present.
X223 349 2310F NM1 010	REFERRING PROVIDER NAME Loop	N/A	N/A	N/A	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	One iteration of this loop is allowed.
X223A1 12 2310F NM1 020	REFERRING PROVIDER NAME	N/A	1	S	N/A	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2310F.NM1 with NM101 = "DN" is allowed.
X223 349 2310F NM101 010	Entity Identifier Code	ID	2-3	R	N/A	DN	999	IK304 = 2: "Unexpected segment"	2310F.NM101 must be present and a valid value.
X223 349 2310F NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2310F.NM102 must be present.
X223 349 2310F NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310F.NM102 must be "1".
X223 349 2310F NM103 010	Referring Provider Last Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310F.NM103 must be present.
X223 349 2310F NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310F.NM103 must contain at least one non-space character.
X223 349 2310F NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310F.NM103 must be 1 - 60 characters.
X223 349 2310F NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: DN "Referring Provider"	N/A
X223 349 2310F NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310F.NM103 must be populated with accepted AN characters.
X223 349 2310F NM104 010	Referring Provider First Name	AN	1-35	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310F.NM104 must contain at least one non-space character.
X223 349 2310F NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310F.NM104 must be 1 - 35 characters.
X223 349 2310F NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: DN "Referring Provider"	N/A
X223 349 2310F NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310F.NM104 must be populated with accepted AN characters.
X223 349 2310F NM105 010	Referring Provider Middle Name	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310F.NM105 must contain at least one non-space character.
X223 349 2310F NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310F.NM105 must be 1 - 25 characters.
X223 349 2310F NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: DN "Referring Provider"	N/A
X223 349 2310F NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310F.NM105 must be populated with accepted AN characters.
X223 349 2310F NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: DN "Referring Provider"	The first position of 2310F.NM105 must be alphabetic (A...Z).
X223 349 2310F NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 349 2310F NM107 010	Referring Provider Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310F.NM107 must contain at least one non-space character.
X223 349 2310F NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2310F.NM107 must be 1 - 10 characters.
X223 349 2310F NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: DN "Referring Provider"	N/A
X223 349 2310F NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2310F.NM107 must be populated with accepted AN characters.
X223 349 2310F NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: DN "Referring Provider"	2310F.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 349 2310F NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: DN "Referring Provider"	2310F.NM108 must be present.
X223 349 2310F NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2310F.NM108 must be "XX".
X223 349 2310F NM109 010	Referring Provider Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2310F.NM109 must be present if 2310F.NM108 is present.
X223 349 2310F NM109 015	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 10: "Exclusion Condition Violated"	2310F.NM109 must not = 2310A.NM109.
X223 349 2310F NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: DN "Referring Provider"	2310F.NM109 must be valid according to the NPI algorithm.
X223 349 2310F NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: DN "Referring Provider"	The first position of 2310F.NM109 must be a "1".
X223 349 2310F NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 349 2310F NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 349 2310F NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 352 2310F REF 005	REFERRING PROVIDER SECONDARY IDENTIFICATION	N/A	3	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2310F.NM109 is not present, 2310F.REF with REF01 = "1G" must be present.
X223 352 2310F REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: DN "Referring Provider"	Only 1 iteration of 2310F.REF with REF01 = "1G" is allowed.
X223 352 2310F REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2310F.REF01 must not be present.
X223 352 2310F REF01 010	Reference Identification Qualifier	N/A	N/A	N/A	N/A	0B, 1G, G2	999	IK403 = 1: "Required Data Element Missing"	2310F.REF01 must be present.
X223 352 2310F REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: DN "Referring Provider"	2310F.REF01 must be "1G".
X223 352 2310F REF02 010	Referring Provider Secondary Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2310F.REF02 must be present.
X223 352 2310F REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" EIC: DN "Referring Provider"	2310F.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 352 2310F REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 352 2310F REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 354 2320 010	OTHER SUBSCRIBER LOOP	N/A	N/A	N/A	10	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Up to ten iterations of the 2320 loop are allowed.
X223 354 2320 SBR01 010	Payer Responsibility Sequence Number Code	ID	1-1	R	N/A	A, B, C, D, E, F, G, H, P, S, T, U	999	IK403 = 1: "Required Data Element Missing"	2320.SBR01 must be present.
X223 354 2320 SBR01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2320.SBR01 must be valid values.
X223 354 2320 SBR01 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	Each iteration of 2320.SBR01 must contain a different code value (each code value may appear in one and only one SBR01 element).
X223 354 2320 SBR01 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 286: "Other payer's Explanation of Benefits/payment information"	If 2000B.SBR01 = "S", 2320.SBR01 ="P" must be present.
X223 354 2320 SBR01 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 286: "Other payer's Explanation of Benefits/payment information"	If 2000B.SBR01 = "T", 2320.SBR01 ="P" must be present in one iteration of 2320.SBR and 2320.SBR01 ="S" must be present in the second iteration of 2320.SBR within the same 2000B loop.
X223 354 2320 SBR02 010	Individual Relationship Code	ID	2-2	R	N/A	01, 18, 19, 20, 21, 39, 40, 53, G8	999	IK403 = 1: "Required Data Element Missing"	2320.SBR02 must be present.
X223 354 2320 SBR02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2320.SBR02 must be valid values.
X223 354 2320 SBR03 004	Insured Group or Policy Number	AN	1-50	S	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	2320.SBR03 must not equal 2330A.NM109
X223 354 2320 SBR03 006	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement/Rejected for relational field in error" CSC 163: "Entity's Policy Number" CSC 732 "Information submitted inconsistent with billing guidelines." EIC: GB "Other Insured"	N/A
X223 354 2320 SBR03 010	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.SBR03 must contain at least one non-space character.
X223 354 2320 SBR03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.SBR03 must be 1-50 characters.
X223 354 2320 SBR03 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 163: "Entity's policy number" EIC: GB "Other Insured"	N/A
X223 354 2320 SBR03 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.SBR03 must be populated with accepted AN characters.
X223 354 2320 SBR04 010	Other Insured Group Name	AN	1-60	S	N/A	N/A	999	IK403 = 10: "Exclusion Condition Violated"	If 2320.SBR04 is present, 2320.SBR03 must not be present.
X223 354 2320 SBR04 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.SBR04 must contain at least one non-space character.
X223 354 2320 SBR04 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.SBR04 must be 1-60 characters.
X223 354 2320 SBR04 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 663: "Entity's Group Name" EIC: GB "Other Insured"	N/A
X223 354 2320 SBR04 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.SBR04 must be populated with accepted AN characters.
X223 354 2320 SBR05 010	Insurance Type Code	ID	1-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 354 2320 SBR06 010	Coordination of Benefits Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 354 2320 SBR07 010	Yes/No Condition or Response Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 354 2320 SBR08 010	Employment Status Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 354 2320 SBR09 010	Claim Filing Indicator Code	ID	1-2	S	N/A	11, 12, 13, 14, 15, 16, 17, AM, BL, CH, CI, DS, FI, HM, LM, MA, MB, MC, OF, TV, VA, WC, ZZ	999	IK403 = 7: "Invalid Code Value"	2320.SBR09 must be valid values.
X223 354 2320 SBR09 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 480: "Entity's claim filing indicator." EIC: PR " Payer"	2320.SBR09 must not be = "MA" or "MB".
X223 358 2320 CAS 010	CLAIM LEVEL ADJUSTMENTS	N/A	5	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present" OR IK304 = 2: "Unexpected Segment"	If 2320.CAS is present, 2320.SBR must be present.
X223 358 2320 CAS 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only 5 iterations of 2320.CAS are allowed.
X223 358 2320 CAS 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 41: Special handling required at payer site CSC 286: Other payer's Explanation of Benefits/payment information CSC 732: Information submitted inconsistent with billing guidelines	If 2000B.SBR01 = "P" then 2320.CAS must not be present.
X223 358 2320 CAS01 010	Claim Adjustment Group Code	ID	1-2	R	N/A	CO, CR, OA, PI, PR	999	IK403 = 1: "Required Data Element Missing"	2320.CAS01 must be present.
X223 358 2320 CAS01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2320.CAS01 must be valid values.
X223 358 2320 CAS01 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 521: "Adjustment Reason Code"	If 2320 CAS01 = "CR", "OA", or "PI": then 2320 CAS02 must not = 45, 2320.CAS05 must not = 45, 2320.CAS08 must not = 45, 2320.CAS11 must not = 45, 2320.CAS14 must not = 45, or 2320.CAS17 must not = 45.
X223 358 2320 CAS02 010	Adjustment Reason Code	ID	1-5	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2320.CAS02 must be present.
X223 358 2320 CAS02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error". CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.CAS02 must be a valid Claim Adjustment Reason Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 358 2320 CAS02 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is not present, 2320.CAS02 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 358 2320 CAS03 010	Adjustment Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2320.CAS03 must be present.
X223 358 2320 CAS03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.CAS03 must be numeric.
X223 358 2320 CAS03 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS03 must be >= -99,999,999.99. and <= 99,999,999.99.
X223 358 2320 CAS03 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS03 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS03 must not = 0.
X223 358 2320 CAS03 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS03 is limited to 0, 1 or 2 decimal positions.
X223 358 2320 CAS04 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS04 must be 1-15 digits.
X223 358 2320 CAS04 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS04 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2320.CAS04 must not = 0.
X223 358 2320 CAS05 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS05 is present, 2320.CAS02 must be present.
X223 358 2320 CAS05 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.CAS05 must be a valid Claim Adjustment Reason Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 358 2320 CAS05 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is not present, 2320.CAS05 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 358 2320 CAS06 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS06 is present, 2320.CAS05 must be present.
X223 358 2320 CAS06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.CAS06 must be numeric.
X223 358 2320 CAS06 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS06 must be >= -99,999,999.99. and <= 99,999,999.99.
X223 358 2320 CAS06 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS06 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS06 must not = 0.
X223 358 2320 CAS06 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS06 is limited to 0, 1 or 2 decimal positions.
X223 358 2320 CAS07 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS07 is present, 2320.CAS05 must be present.
X223 358 2320 CAS07 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS07 must be 1-15 digits.
X223 358 2320 CAS07 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS07 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2320.CAS07 must not = 0.
X223 358 2320 CAS08 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS08 is present, 2320.CAS05 must be present.
X223 358 2320 CAS08 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.CAS08 must be a valid Claim Adjustment Reason Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 358 2320 CAS08 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is not present, 2320.CAS08 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 358 2320 CAS09 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS09 is present, 2320.CAS08 must be present.
X223 358 2320 CAS09 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.CAS09 must be numeric.
X223 358 2320 CAS09 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS09 must be >= -99,999,999.99. and <= 99,999,999.99.
X223 358 2320 CAS09 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS09 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS09 must not = 0.
X223 358 2320 CAS09 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS09 is limited to 0, 1 or 2 decimal positions.
X223 358 2320 CAS10 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS10 is present, 2320.CAS08 must be present.
X223 358 2320 CAS10 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS10 must be 1-15 digits.
X223 358 2320 CAS10 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS10 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2320.CAS10 must not = 0.
X223 358 2320 CAS11 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS11 is present, 2320.CAS08 must be present.
X223 358 2320 CAS11 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.CAS11 must be a valid Claim Adjustment Reason Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 358 2320 CAS11 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is not present, 2320.CAS11 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 358 2320 CAS12 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS12 is present, 2320.CAS11 must be present.
X223 358 2320 CAS12 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.CAS12 must be numeric.
X223 358 2320 CAS12 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS12 must be >= -99,999,999.99. and <= 99,999,999.99.
X223 358 2320 CAS12 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS12 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS12 must not = 0.
X223 358 2320 CAS12 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS12 is limited to 0, 1 or 2 decimal positions.
X223 358 2320 CAS13 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS13 is present, 2320.CAS11 must be present.
X223 358 2320 CAS13 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS13 must be 1-15 digits.
X223 358 2320 CAS13 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS13 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2320.CAS13 must not = 0.
X223 358 2320 CAS14 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS14 is present, 2320.CAS11 must be present.
X223 358 2320 CAS14 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.CAS14 must be a valid Claim Adjustment Reason Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 358 2320 CAS14 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is not present, 2320.CAS14 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 358 2320 CAS15 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS15 is present, 2320.CAS14 must be present.
X223 358 2320 CAS15 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.CAS15 must be numeric.
X223 358 2320 CAS15 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS15 must be >= -99,999,999.99. and <= 99,999,999.99.
X223 358 2320 CAS15 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS15 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS15 must not = 0.
X223 358 2320 CAS15 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS15 is limited to 0, 1 or 2 decimal positions.
X223 358 2320 CAS16 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS16 is present, 2320.CAS14 must be present.
X223 358 2320 CAS16 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS16 must be 1-15 digits.
X223 358 2320 CAS16 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS16 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2320.CAS16 must not = 0.
X223 358 2320 CAS17 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS17 is present, 2320.CAS14 must be present.
X223 358 2320 CAS17 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.CAS17 must be a valid Claim Adjustment Reason Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 358 2320 CAS17 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is not present, 2320.CAS17 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 358 2320 CAS18 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS18 is present, 2320.CAS17 must be present.
X223 358 2320 CAS18 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.CAS18 must be numeric.
X223 358 2320 CAS18 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS18 must be >= -99,999,999.99. and <= 99,999,999.99.
X223 358 2320 CAS18 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS18 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS18 must not = 0.
X223 358 2320 CAS18 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS18 is limited to 0, 1 or 2 decimal positions.
X223 358 2320 CAS19 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2If 2320.CAS19 is present, 2320.CAS17 must be present.
X223 358 2320 CAS19 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS19 must be 1-15 digits.
X223 358 2320 CAS19 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 358 2320 CAS19 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2320.CAS19 must not = 0.
X223 364 2320 AMT 020	COB PAYER PAID AMOUNT	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2320.AMT with AMT01 = "D" is allowed within the 2320 loop.
X223 364 2320 AMT 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 286: "Other payer's Explanation of Benefits/payment information"	If 2000B.SBR01 = "S" then one 2320 loop with an AMT segment with AMT01 = "D" must be present.
X223 364 2320 AMT 035	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 286: "Other payer's Explanation of Benefits/payment information"	If 2000B.SBR01 = "T" then two 2320 loops with two 2320.AMT segments with AMT01 = "D" (one in each loop) must be present.
X223 364 2320 AMT 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 41: Special handling required at payer site CSC 286: Other payer's Explanation of Benefits/payment information CSC 732: Information submitted inconsistent with billing guidelines	If 2000B.SBR01 = "S" then only one iteration of 2320 loop containing an AMT with AMT01 equal to "D" is allowed.
X223 364 2320 AMT 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 41: Special handling required at payer site CSC 286: Other payer's Explanation of Benefits/payment information CSC 732: Information submitted inconsistent with billing guidelines	If 2000B.SBR01 = "T" then only two 2320 loops with two 2320.AMT segments with AMT01 = "D" (one in each loop) must be present.
X223 364 2320 AMT01 010	Amount Qualifier Code	ID	1-3	R	N/A	D	999	IK403 = 1: "Required Data Element Missing"	2320.AMT01 must be present.
X223 364 2320 AMT01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2320.AMT01 must be "D".
X223 364 2320 AMT01 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 41: Special handling required at payer site CSC 286: Other payer's Explanation of Benefits/payment information CSC 732: Information submitted inconsistent with billing guidelines	If 2000B.SBR01 = "P" then 2320.AMT with AMT01 = "D" must not be present.
X223 364 2320 AMT02 005	Payer Paid Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2320.AMT02 must be present.
X223 364 2320 AMT02 010	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.AMT02 must be numeric.
X223 364 2320 AMT02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.AMT02 must be >= 0 and <= 99,999,999.99.
X223 364 2320 AMT02 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 183: "Amount entity has paid" CSC 286: "Other payer's Explanation of Benefits/payment information" EIC: PR "Payer"	N/A
X223 364 2320 AMT02 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 183: "Amount entity has paid" CSC 286: "Other payer's Explanation of Benefits/payment information" EIC: PR "Payer"	2320.AMT02 is limited to 0, 1 or 2 decimal positions.
X223 364 2320 AMT03 010	Credit/Debit Flag Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 365 2320 AMT 020	REMAINING PATIENT LIABILITY	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2320.AMT with AMT01 = "EAF" is allowed.
X223 365 2320 AMT 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field..." CSC 6: Balance due from the subscriber EIC: GB "Other Insured"	If 2430 AMT (EAF) is present for the same payer, the 2320 AMT (EAF) must not be present.
X223 365 2320 AMT01 010	Amount Qualifier Code	ID	1-3	R	N/A	EAF	999	IK403 = 1: "Required Data Element Missing"	2320.AMT01 must be present.
X223 365 2320 AMT01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2320.AMT01 must be "EAF".
X223 365 2320 AMT02 005	Remaining Patient Liability Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2320.AMT02 must be present.
X223 365 2320 AMT02 010	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320 .AMT02 must be numeric.
X223 365 2320 AMT02 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 693: "Amount must be greater than or equal to zero" CSC 6: "Balance due from the subscriber" EIC: GB "Other Insured"	2320.AMT02 must be >= 0.
X223 365 2320 AMT02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.AMT02 must be <= 99,999,999.99.
X223 365 2320 AMT02 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 6: "Balance due from the subscriber" EIC: GB "Other Insured"	N/A
X223 365 2320 AMT02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 6: "Balance due from the subscriber" EIC: GB "Other Insured"	2320.AMT02 is limited to 0, 1 or 2 decimal positions.
X223 365 2320 AMT03 010	Credit/Debit Flag Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 366 2320 AMT 020	COB TOTAL NON-COVERED AMOUNT	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2320.AMT with AMT01 = "A8" is allowed.
X223 366 2320 AMT01 010	Amount Qualifier Code	ID	1-3	R	N/A	A8	999	IK403 = 1: "Required Data Element Missing"	2320.AMT01 must be present.
X223 366 2320 AMT01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2320.AMT01 must be "A8".
X223 366 2320 AMT01 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 596: "Non-covered Charge Amount" EIC: GB "Other Insured"	2320 AMT01 = A8 must not be present.
X223 366 2320 AMT02 005	Non-Covered Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2320.AMT02 must be present.
X223 366 2320 AMT02 010	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.AMT02 must be numeric.
X223 366 2320 AMT02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.AMT02 must be >= 0 and <= 99,999,999.99.
X223 366 2320 AMT02 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 596: "Non-covered Charge Amount" EIC: GB "Other Insured"	N/A
X223 366 2320 AMT02 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 596: "Non-covered Charge Amount" EIC: GB "Other Insured"	2320.AMT02 is limited to 0, 1 or 2 decimal positions.
X223 366 2320 AMT03 010	Credit/Debit Flag Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 367 2320 OI 010	OTHER INSURANCE COVERAGE INFORMATION	N/A	1	R	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2320.SBR is present, 2320.OI must be present.
X223 367 2320 OI 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2320.OI is allowed.
X223 367 2320 OI01 010	Claim Filing Indicator Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 367 2320 OI02 010	Claim Submission Reason Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 367 2320 OI03 010	Benefits Assignment Certification Indicator	ID	1-1	R	N/A	N, W, Y	999	IK403 = 1: "Required Data Element Missing"	2320.OI03 must be present.
X223 367 2320 OI03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2320.OI03 must be valid values.
X223 367 2320 OI04 010	Patient Signature Source Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 367 2320 OI05 010	Provider Agreement Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 367 2320 OI06 010	Release of Information Code	ID	1-1	R	N/A	I, Y	999	IK403 = 1: "Required Data Element Missing"	2320.OI06 must be present.
X223 367 2320 OI06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2320.OI06 must be valid values.
X223 369 2320 MIA 020	INPATIENT ADJUDICATION INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2320.MIA is allowed.
X223 369 2320 MIA01 010	Covered Days or Visits Count	R	1-15	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2320.MIA01 must be present.
X223 369 2320 MIA01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.MIA01 must be numeric.
X223 369 2320 MIA01 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 693: "Amount must be greater than or equal to zero" CSC 456: "Covered Day(s)"	2320.MIA01 must be >= 0.
X223 369 2320 MIA02 010	Monetary Amount	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 369 2320 MIA03 010	Lifetime Psychiatric Days	R	1-15	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA03 must be 1-15 characters.
X223 369 2320 MIA03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320.MIA03 must be numeric.
X223 369 2320 MIA03 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 693: "Amount must be greater than or equal to zero" CSC 582: "Lifetime Psychiatric Days Count"	2320.MIA03 must be >= 0.
X223 369 2320 MIA04 010	Claim DRG Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA04 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA04 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 532: "Claim DRG Amount"	N/A
X223 369 2320 MIA04 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 532: "Claim DRG Amount"	2320.MIA04 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA05 010	Claim Payment Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MIA05 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 369 2320 MIA05 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MIA05 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 369 2320 MIA06 010	Claim Disproportionate Share Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA06 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA06 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 531: "Claim Disproportionate Share Amount"	N/A
X223 369 2320 MIA06 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 531: "Claim Disproportionate Share Amount"	2320.MIA06 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA07 010	Claim MSP Pass-through Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA07 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA07 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 537: "Claim MSP Pass-through Amount"	N/A
X223 369 2320 MIA07 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 537: "Claim MSP Pass-through Amount"	2320.MIA07 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA08 010	Claim PPS Capital Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA08 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA08 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 539: "Claim PPS Capital Amount"	N/A
X223 369 2320 MIA08 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 539: "Claim PPS Capital Amount"	2320.MIA08 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA09 010	PPS-Capital FSP DRG Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA09 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA09 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 620: "PPS-Capital FSP DRG Amount"	N/A
X223 369 2320 MIA09 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 620: "PPS-Capital FSP DRG Amount"	2320.MIA09 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA10 010	PPS-Capital HSP DRG Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA10 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA10 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 621: "PPS-Capital HSP DRG Amount"	N/A
X223 369 2320 MIA10 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 621: "PPS-Capital HSP DRG Amount"	2320.MIA10 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA11 010	PPS-Capital DSH DRG Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA11 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA11 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 618: "PPS-Capital DSH DRG Amount"	N/A
X223 369 2320 MIA11 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 618: "PPS-Capital DSH DRG Amount"	2320.MIA11 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA12 010	Old Capital Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA12 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA12 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 603: "Old Capital Amount"	N/A
X223 369 2320 MIA12 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 603: "Old Capital Amount"	2320.MIA12 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA13 010	PPS-Capital IME Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA13 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA13 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 622: "PPS-Capital IME Amount"	N/A
X223 369 2320 MIA13 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 622: "PPS-Capital IME Amount"	2320.MIA13 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA14 010	PPS-Operating Hospital Specific DRG Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA14 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA14 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 624: "PPS-Operating Hospital Specific DRG Amount"	N/A
X223 369 2320 MIA14 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 624: "PPS-Operating Hospital Specific DRG Amount"	2320.MIA14 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA15 010	Cost Report Day Count	R	1-15	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA15 must be 1-15 characters.
X223 369 2320 MIA15 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320 .MIA15 must be numeric.
X223 369 2320 MIA15 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 693: "Amount must be greater than or equal to zero" CSC 552: "Cost Report Day Count"	2320.MIA15 must be >= 0.
X223 369 2320 MIA16 010	PPS-Operating Federal Specific DRG Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA16 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA16 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 623: "PPS-Operating Federal Specific DRG Amount"	N/A
X223 369 2320 MIA16 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 623: "PPS-Operating Federal Specific DRG Amount"	2320.MIA16 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA17 010	Claim PPS Capital Outlier Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA17 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA17 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 540: "Claim PPS Capital Outlier Amount"	N/A
X223 369 2320 MIA17 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 540: "Claim PPS Capital Outlier Amount"	2320.MIA17 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA18 010	Claim Indirect Teaching Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA18 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA18 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 536: "Claim Indirect Teaching Amount"	N/A
X223 369 2320 MIA18 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 536: "Claim Indirect Teaching Amount"	2320.MIA18 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA19 010	Non-Payable Professional Component Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA19 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA19 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 597: "Non-payable Professional Component Amount"	N/A
X223 369 2320 MIA19 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 597: "Non-payable Professional Component Amount"	2320.MIA19 is limited to 0, 1 or 2 decimal positions.
X223 369 2320 MIA20 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MIA20 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 369 2320 MIA20 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MIA20 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 369 2320 MIA21 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MIA21 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 369 2320 MIA21 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MIA21 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 369 2320 MIA22 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MIA22 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 369 2320 MIA22 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MIA22 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 369 2320 MIA23 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MIA23 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 369 2320 MIA23 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MIA23 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 369 2320 MIA24 010	PPS-Capital Exception Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MIA24 must be >= 0 and <= 99,999,999.99.
X223 369 2320 MIA24 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 619: "PPS-Capital Exception Amount"	N/A
X223 369 2320 MIA24 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 619: "PPS-Capital Exception Amount"	2320.MIA24 is limited to 0, 1 or 2 decimal positions.
X223 374 2320 MOA 020	OUTPATIENT ADJUDICATION INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2320.MOA is allowed.
X223 374 2320 MOA01 010	Reimbursement Rate	R	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2320 .MOA01 must be numeric.
X223 374 2320 MOA01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	2320 .MOA01 must be >= 0.0 and <= 1.0.
X223 374 2320 MOA01 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 631: "Reimbursement Rate"	2320.MOA01 is limited to 0, 1 or 2 decimal positions.
X223 374 2320 MOA02 020	Claim HCPCS Payable Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MOA02 must be >= 0 and <= 99,999,999.99.
X223 374 2320 MOA02 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 574: "HCPCS Payable Amount Home Health"	N/A
X223 374 2320 MOA02 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 574: "HCPCS Payable Amount Home Health"	2320.MOA02 is limited to 0, 1 or 2 decimal positions.
X223 374 2320 MOA03 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MOA03 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 374 2320 MOA03 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MOA03 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 374 2320 MOA04 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MOA04 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 374 2320 MOA04 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MOA04 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 374 2320 MOA05 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MOA05 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 374 2320 MOA05 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MOA05 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 374 2320 MOA06 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MOA06 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 374 2320 MOA06 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MOA06 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 374 2320 MOA07 010	Remark Code	AN	1-50	S	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If 2330B.DTP03 with DTP01 = "573" is present, 2320.MOA07 must be a valid Remark Code on the date in 2330B.DTP03 when DTP01 = "573".
X223 374 2320 MOA07 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 634: "Remark Code" CSC 516: "Adjudication or Payment Date" EIC: GB "Other Insured"	If DTP03 with DTP01 = "573" is not present, 2320.MOA07 must be a valid Remark Code on the date in 2430.DTP03 when DTP01 = "573".
X223 374 2320 MOA08 020	Claim ESRD Payment Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MOA08 must be >= 0 and <= 99,999,999.99.
X223 374 2320 MOA08 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 534: "Claim ESRD Payment Amount"	N/A
X223 374 2320 MOA08 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 534: "Claim ESRD Payment Amount"	2320.MOA08 is limited to 0, 1 or 2 decimal positions.
X223 374 2320 MOA09 020	Non-Payable Professional Component Amount	R	1-18	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.MOA09 must be >= 0 and <= 99,999,999.99.
X223 374 2320 MOA09 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 598: "Non-payable Professional Component Billed Amount"	N/A
X223 374 2320 MOA09 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 598: "Non-payable Professional Component Billed Amount"	2320.MOA09 is limited to 0, 1 or 2 decimal positions.
X223 377 2330A NM1 010	OTHER SUBSCRIBER NAME	N/A	1	R	1	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2320.SBR is present, 2330A.NM1 must be present.
X223 377 2330A NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2330A.NM1 is allowed.
X223 377 2330A NM101 010	Entity Identifier Code	ID	2-3	R	N/A	IL	999	IK304 = 2: "Unexpected segment"	2330A.NM101 must be present and a valid value.
X223 377 2330A NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1, 2	999	IK403 = 1: "Required Data Element Missing"	2330A.NM102 must be present.
X223 377 2330A NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330A.NM102 must be valid values.
X223 377 2330A NM103 010	Other Insured Last Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330A.NM103 must be present.
X223 377 2330A NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330A.NM103 must be 1-60 characters.
X223 377 2330A NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: GB "Other Insured"	N/A
X223 377 2330A NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM103 must be populated with accepted AN characters.
X223 377 2330A NM103 060	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM103 must contain at least one non-space character.
X223 377 2330A NM104 010	Other Insured First Name	AN	1-35	S	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	If 2330A.NM102 is "2", 2330A.NM104 must not be present.
X223 377 2330A NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM104 must contain at least one non-space character.
X223 377 2330A NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330A.NM104 must be 1 - 35 characters.
X223 377 2330A NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: GB "Other Insured"	N/A
X223 377 2330A NM104 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM104 must be populated with accepted AN characters.
X223 377 2330A NM105 010	Other Insured Middle Name	AN	1-25	S	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	If 2330A.NM102 is "2", 2330A.NM105 must not be present.
X223 377 2330A NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM105 must contain at least one non-space character.
X223 377 2330A NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330A.NM105 must be 1 - 25 characters.
X223 377 2330A NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: GB "Other Insured"	N/A
X223 377 2330A NM105 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM105 must be populated with accepted AN characters.
X223 377 2330A NM105 055	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: GB "Other Insured"	The first position of 2330A.NM105 must be alphabetic (A...Z).
X223 377 2330A NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 377 2330A NM107 010	Other Insured Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = I13: "Implementation Dependent "Not Used" Data Element Present"	If 2330A.NM102 is "2", 2330A.NM107 must not be present.
X223 377 2330A NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM107 must contain at least one non-space character.
X223 377 2330A NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330A.NM107 must be 1 - 10 characters.
X223 377 2330A NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: GB "Other Insured"	N/A
X223 377 2330A NM107 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM107 must be populated with accepted AN characters.
X223 377 2330A NM108 010	Identification Code Qualifier	ID	1-2	R	N/A	II, MI	999	IK403 = 1: "Required Data Element Missing"	2330A.NM108 must be present.
X223 377 2330A NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330A.NM108 must be valid values.
X223 377 2330A NM109 010	Other Insured Identifier	AN	2-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330A.NM109 must be present.
X223 377 2330A NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM109 must contain at least two non-space characters.
X223 377 2330A NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2330A.NM109 must be 2-80 characters.
X223 377 2330A NM109 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 153: "Entity's ID Number" EIC: GB "Other Insured"	N/A
X223 377 2330A NM109 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.NM109 must be populated with accepted AN characters.
X223 377 2330A NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 377 2330A NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 377 2330A NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 380 2330A N3 020	OTHER SUBSCRIBER ADDRESS	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330A.N3 is allowed.
X223 380 2330A N301 010	Other Insured Address Line	AN	1-55	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330A.N301 must be present.
X223 380 2330A N301 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330AN301 must contain at least one non-space character.
X223 380 2330A N301 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330A.N301 must be 1-55 characters.
X223 380 2330A N301 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street address" EIC: GB "Other Insured"	N/A
X223 380 2330A N301 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.N301 must be populated with accepted AN characters.
X223 380 2330A N302 020	Other Insured Address Line	AN	1-55	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If present, 2330A.N302 must contain at least one non-space character.
X223 380 2330A N302 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330A.N302 must be 1-55 characters.
X223 380 2330A N302 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street address" EIC: GB "Other Insured"	N/A
X223 380 2330A N302 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.N302 must be populated with accepted AN characters.
X223A2 21 2330A N4 020	OTHER SUBSCRIBER CITY/STATE/ZIP CODE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330A.N4 is allowed.
X223 381 2330A N401 010	Other Insured City Name	AN	2-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330A.N401 must be present.
X223 381 2330A N401 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.N401 must contain at least two non-space characters.
X223 381 2330A N401 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2330A.N401 must be 2-30 characters.
X223 381 2330A N401 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 502: "Entity's City" EIC: GB "Other Insured"	N/A
X223 381 2330A N401 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330A.N401 must be populated with accepted AN characters.
X223 381 2330A N402 010	Other Insured State Code	ID	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2330A.N404 is not present, 2330A.N402 must be present.
X223 381 2330A N402 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 501: "Entity's State/Province" EIC: GB "Other Insured"	2330A.N402 must be a valid state code.
X223 381 2330A N403 010	Other Insured Postal Zone or ZIP Code	ID	3-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2330A.N404 is not present, 2330A.N403 must be present.
X223 381 2330A N403 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 500: "Entity's Postal/Zip Code" EIC: GB "Other Insured"	2330A.N403 must be a valid postal/zip Code when N404 equals US or blank.
X223 381 2330A N404 010	Country Code	ID	2-3	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 680: "Entity's Country" EIC: IL "Subscriber"	2330A.N404 must be a valid 2 character Country Code.
X223 381 2330A N405 010	Location Qualifier	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 381 2330A N406 010	Location Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 381 2330A N407 010	Location Identifier	AN	1-30	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 695: "Entity's Country Subdivision Code" EIC: IL "Subscriber"	2330A.N407 must be a valid Country Subdivision Code.
X223 383 2330A REF 020	OTHER SUBSCRIBER SECONDARY IDENTIFICATION	N/A	2	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330A.REF is allowed.
X223 383 2330A REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	SY	999	IK403 = 1: "Required Data Element Missing"	2330A.REF01 must be present.
X223 383 2330A REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330A.REF01 must be "SY".
X223 383 2330A REF02 010	Other Insured Additional Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330A.REF02 must be present.
X223 383 2330A REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 148: "Entity's Social Security Number" EIC: GB "Other Insured"	2330A.REF02 must be 9 digits, with no punctuation. The first 3 digits cannot be higher than 772, and digits 1-3, 4-5, and 6-9 cannot be zeroes.
X223 383 2330A REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 383 2330A REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 384 2330B NM1 010	OTHER PAYER NAME	N/A	1	R	1	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	Per Payer, If 2320.SBR is present, 2330B.NM1 must be present.
X223 384 2330B NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Per Payer, Only one iteration of 2330B.NM1 is allowed.
X223 384 2330B NM1 020 Edit Deactivated	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2330.NM1 is allowed.
X223 384 2330B NM101 010	Entity Identifier Code	ID	2-3	R	N/A	PR	999	IK304 = 2: "Unexpected segment"	2330B.NM101 must be present and a valid value.
X223 384 2330B NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	2	999	IK403 = 1: "Required Data Element Missing"	2330B.NM102 must be present.
X223 384 2330B NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.NM102 must be "2".
X223 384 2330B NM103 010	Other Payer Last or Organization Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.NM103 must be present.
X223 384 2330B NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.NM103 must contain at least one non-space character.
X223 384 2330B NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2300B.NM103 must be 1-60 characters.
X223 384 2330B NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" CSC 286: Other payer's Explanation of Benefits/payment information EIC: PR "Payer"	N/A
X223 384 2330B NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.NM103 must be populated with accepted AN characters.
X223 384 2330B NM104 010	Name First	AN	1-35	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 384 2330B NM105 010	Name Middle	AN	1-25	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 384 2330B NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 384 2330B NM107 010	Name Suffix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 384 2330B NM108 010	Identification Code Qualifier	ID	1-2	R	N/A	PI, XV	999	IK403 = 1: "Required Data Element Missing"	2330B.NM108 must be present.
X223 384 2330B NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.NM108 must be valid values.
X223 384 2330B NM109 010	Other Payer Primary Identifier	AN	2-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.NM109 must be present.
X223 384 2330B NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	2330B.NM109 must = 2430.SVD01.
X223 384 2330B NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines. " CSC 479: "Other Carrier payer ID is missing or invalid"	Each iteration of 2330B NM109 must be unique.
X223 384 2330B NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 384 2330B NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 384 2330B NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 386 2330B N3 020	OTHER PAYER ADDRESS	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330B.N3 is allowed.
X223 386 2330B N301 010	Other Payer Address Line	AN	1-55	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.N301 must be present.
X223 386 2330B N301 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.N301 must contain at least one non-space character.
X223 386 2330B N301 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330B.N301 must be 1-55 characters.
X223 386 2330B N301 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street address" CSC 286: Other payer's Explanation of Benefits/payment information EIC: PR "Payer"	N/A
X223 386 2330B N301 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.N301 must be populated with accepted AN characters.
X223 386 2330B N302 020	Other Payer Address Line	AN	1-55	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If present, 2330B.N302 must contain at least one non-space character.
X223 386 2330B N302 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330B.N302 must be 1-55 characters.
X223 386 2330B N302 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 503: "Entity's Street address" CSC 286: Other payer's Explanation of Benefits/payment information EIC: PR "Payer"	N/A
X223 386 2330B N302 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.N302 must be populated with accepted AN characters.
X223A2 22 2330B N4 020	OTHER PAYER CITY/STATE/ZIP CODE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330B.N4 is allowed.
X223 387 2330B N401 010	Other Payer City Name	AN	2-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.N401 must be present.
X223 387 2330B N401 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.N401 must contain at least two non-space characters.
X223 387 2330B N401 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2330B.N401 must be 2-30 characters.
X223 387 2330B N401 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 502: "Entity's City" CSC 286: Other payer's Explanation of Benefits/payment information EIC: PR "Payer"	N/A
X223 387 2330B N401 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.N401 must be populated with accepted AN characters.
X223 387 2330B N402 010	Other Payer State Code	ID	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2330B.N404 is not present, 2330B.N402 must be present.
X223 387 2330B N402 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 501: "Entity's State/Province" CSC 286: Other payer's Explanation of Benefits/payment information EIC: PR "Payer"	2330B.N402 must be a valid state code.
X223 387 2330B N403 010	Other Payer Postal Zone or ZIP Code	ID	3-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2330B.N404 is not present, 2330B.N403 must be present.
X223 387 2330B N403 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 500: "Entity's Postal/Zip Code" CSC 286: Other payer's Explanation of Benefits/payment information EIC: PR "Payer"	2330B.N403 must be a valid US zip code when N404 is US or blank.
X223 387 2330B N404 020	Country Code	ID	2-3	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 680: "Entity's Country" CSC 286: Other payer's Explanation of Benefits/payment information EIC: PR "Payer"	2330B.N404 must be a valid 2 character Country Code.
X223 387 2330B N405 010	Location Qualifier	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 387 2330B N406 010	Location Identifier	AN	1-30	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 387 2330B N407 020	Country Subdivision Code	AN	1-30	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 695: "Entity's Country Subdivision Code" CSC 286: Other payer's Explanation of Benefits/payment information EIC: PR "Payer"	2330B.N407 must be a valid Country Subdivision Code.
X223 389 2330B DTP 020	CLAIM CHECK OR REMITTANCE DATE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Per Payer, Only one iteration of 2330B.DTP is allowed.
X223 389 2330B DTP 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 2: "Unexpected Segment"	Per Payer, If 2430 DTP with 573 is present, then 2330B DTP must not be present.
X223 389 2330B DTP01 010	Date Time Qualifier	ID	3-3	R	N/A	573	999	IK403 = 1: "Required Data Element Missing"	2330B.DTP01 must be present.
X223 389 2330B DTP01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.DTP01 must be "573"
X223 389 2330B DTP02 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 1: "Required Data Element Missing"	2330B.DTP02 must be present.
X223 389 2330B DTP02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.DTP02 must be "D8".
X223 389 2330B DTP03 010	Adjudication or Payment Date	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 8: "Invalid Date"	2330B.DTP03 must a valid date in CCYYMMDD format.
X223 389 2330B DTP03 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 510: "Future date" CSC 516 "Adjudication or Payment Date"	2330B.DTP03 must not be a future date.
X223 390 2330B REF 010	OTHER PAYER SECONDARY IDENTIFIER	N/A	2	S	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2330B.NM1 is present, 2330B.REF with REF01 = "2U", "EI", "FY" or "NF" may be present.
X223 390 2330B REF 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only two iterations of 2330B.REF with REF01 = "2U", "EI", "FY" or "NF" are allowed.
X223 390 2330B REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	2U, EI, FY, NF	999	IK403 = 1: "Required Data Element Missing"	2330B.REF01 must be present.
X223 390 2330B REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.REF01 must be valid values.
X223 390 2330B REF02 010	Other Payer Secondary Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.REF02 must be present.
X223 390 2330B REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 128: "Entity's tax id" EIC: PR "Payer"	If 2330B.REF01 = "EI", 2330B.REF02 must be 9 digits with no punctuation.
X223 390 2330B REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	If 2330B.REF01 = "2U", "FY" or "NF", 2330B.REF02 must be must be 1-50 characters.
X223 390 2330B REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If 2330B.REF01 = "2U", "FY" or "NF", 2330B.REF02 must be populated with accepted AN characters.
X223 390 2330B REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	If 2330B.REF01 = "2U", "FY" or "NF", 2330B.REF02 must contain at least one non-space character.
X223 390 2330B REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 390 2330B REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 392 2330B REF 010	OTHER PAYER PRIOR AUTHORIZATION NUMBER	N/A	1	S	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2330B.NM1 is present, 2330B.REF with REF01 = "G1" may be present.
X223 392 2330B REF 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330B.REF with REF01 = "G1" is allowed.
X223 392 2330B REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	G1	999	IK403 = 1: "Required Data Element Missing"	2330B.REF01 must be present.
X223 392 2330B REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.REF01 must be "G1".
X223 392 2330B REF02 010	Other Payer Prior Authorization or Referral Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.REF02 must be present.
X223 392 2330B REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330B.REF02 must be 1-50 characters.
X223 392 2330B REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.REF02 must be populated with accepted AN characters.
X223 392 2330B REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.REF02 must contain at least one non-space character.
X223 392 2330B REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 392 2330B REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 393 2330B REF 010	OTHER PAYER REFERRAL NUMBER	N/A	1	S	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2330B.NM1 is present, 2330B.REF with REF01 = "9F" may be present.
X223 393 2330B REF 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330B.REF with REF01 = "9F" is allowed.
X223 393 2330B REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	9F	999	IK403 = 1: "Required Data Element Missing"	2330B.REF01 must be present.
X223 393 2330B REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.REF01 must be "9F".
X223 393 2330B REF02 010	Other Payer Referral Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.REF02 must be present.
X223 393 2330B REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330B.REF02 must be 1-50 characters.
X223 393 2330B REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330.REF02 must be populated with accepted AN characters.
X223 393 2330B REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2300.REF02 must contain at least one non-space character.
X223 393 2330B REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 393 2330B REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 394 2330B REF 010	OTHER PAYER CLAIM ADJUSTMENT INDICATOR	N/A	1	S	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2330B.NM1 is present, 2330B.REF with REF01 = "T4" may be present.
X223 394 2330B REF 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330B.REF with REF01 = "T4" is allowed.
X223 394 2330B REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	T4	999	IK403 = 1: "Required Data Element Missing"	2330B.REF01 must be present.
X223 394 2330B REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.REF01 must be "T4".
X223 394 2330B REF02 010	Other Payer Claim Adjustment Indicator	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.REF02 must be present.
X223 394 2330B REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.REF02 must be = "Y".
X223 394 2330B REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 394 2330B REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 395 2330B REF 010	OTHER PAYER CLAIM CONTROL NUMBER	N/A	1	S	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2330B.NM1 is present, 2330B.REF with REF01 = "F8" may be present.
X223 395 2330B REF 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2330B.REF with REF01 = "F8" is allowed.
X223 395 2330B REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	F8	999	IK403 = 1: "Required Data Element Missing"	2330B.REF01 must be present.
X223 395 2330B REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2330B.REF01 must be "F8".
X223 395 2330B REF02 010	Other Payer Claim Control Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2330B.REF02 must be present.
X223 395 2330B REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2330B.REF02 must be 1-50 characters.
X223 395 2330B REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.REF02 must be populated with accepted AN characters.
X223 395 2330B REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2330B.REF02 must contain at least one non-space character.
X223 395 2330B REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 395 2330B REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 396 2330C NM1 010	OTHER PAYER ATTENDING PROVIDER	N/A	1	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 562: "Entity's National Provider Identifier (NPI)." EIC: 71 "Attending Physician"	2330C.NM1 must not be present.
X223 398 2330C REF 010	OTHER PAYER ATTENDING PROVIDER SECONDARY IDENTIFICATION	N/A	4	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 71 "Attending Physician"	2330C.REF must not be present.
X223 400 2330D NM1 010	OTHER PAYER OPERATING PHYSICIAN	N/A	1	S	1	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 562: "Entity's National Provider Identifier (NPI)." EIC: 72 "Operating Physician"	2330D.NM1 must not be present.
X223 402 2330D REF 010	OTHER PAYER OPERATING PHYSICIAN SECONDARY IDENTIFICATION	N/A	4	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 72 "Operating Physician"	2330D.REF must not be present.
X223 404 2330E NM1 010	OTHER PAYER OTHER OPERATING PHYSICIAN	N/A	1	S	1	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 562: "Entity's National Provider Identifier (NPI)." EIC: 72 "Operating Physician"	2330E.NM1 must not be present.
X223 406 2330E REF 010	OTHER PAYER OTHER OPERATING PHYSICIAN SECONDARY IDENTIFICATION	N/A	4	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 72 "Operating Physician"	2330E.REF must not be present.
X223 408 2330F NM1 010	OTHER PAYER SERVICE FACILITY LOCATION	N/A	1	S	1	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 562: "Entity's National Provider Identifier (NPI)." EIC: 77 "Service Location"	2330F.NM1 must not be present.
X223 410 2330F REF 010	OTHER PAYER SERVICE FACILITY LOCATION SECONDARY IDENTIFICATION	N/A	3	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 77 "Service Location"	2330F.REF must not be present.
X223 412 2330G NM1 010	OTHER PAYER RENDERING PROVIDER NAME	N/A	1	S	1	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 562: "Entity's National Provider Identifier (NPI)." EIC: 82 "Rendering Provider"	2330G.NM1 must not be present.
X223 414 2330G REF 010	OTHER PAYER RENDERING PROVIDER SECONDARY IDENTIFIER	N/A	4	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 82 "Rendering Provider"	2330G.REF must not be present.
X223 416 2330H NM1 010	OTHER PAYER REFERRING PROVIDER	N/A	1	S	1	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 562: "Entity's National Provider Identifier (NPI)." EIC: DN "Referring Provider"	2330H.NM1 must not be present.
X223 418 2330H REF 010	OTHER PAYER REFERRING PROVIDER SECONDARY IDENTIFIER	N/A	3	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: DN "Referring Provider"	2330H.REF must not be present.
X223 420 2330I NM1 010	OTHER PAYER BILLING PROVIDER	N/A	1	S	1	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 562: "Entity's National Provider Identifier (NPI)." EIC: 85 "Billing Provider"	2330I.NM1 must not be present.
X223 422 2330I REF 010	OTHER PAYER BILLING PROVIDER SECONDARY IDENTIFICATION	N/A	2	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 85 "Billing Provider"	2330I.REF must not be present.
X223 423 2400 010	Service Line Loop	N/A	N/A	N/A	N/A	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only up to 999 iterations of the 2400 loop are allowed.
X223 423 2400 LX 010	SERVICE LINE NUMBER	N/A	1	R	999	N/A	999	IK304 = 3: "Required Segment Missing"	2400.LX must be present.
X223 423 2400 LX 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.LX is allowed.
X223 423 2400 LX01 010	Assigned Number	N0	1-6	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.LX01 must be present.
X223 423 2400 LX01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.LX01 must be numeric.
X223 423 2400 LX01 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A3: "Acknowledgement /Returned as unprocessable claim" CSC 121: "Service line number greater than maximum allowable for payer"	2400.LX01 must be > 0 and <= 449.
X223 423 2400 LX01 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	The first 2400.LX01 must be "1".
X223 423 2400 LX01 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	Subsequent 2400.LX01 values must increment by 1.
X223 424 2400 SV2 010	INSTITUTIONAL SERVICE LINE	N/A	1	R	N/A	N/A	999	IK304 = 3: "Required Segment Missing"	2400.SV2 must be present.
X223 424 2400 SV2 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.SV2 is allowed.
X223 424 2400 SV201 010	Revenue Code	AN	1-48	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.SV201 must be present.
X223 424 2400 SV201 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 455: "Revenue code for services rendered"	2400.SV201 must be a valid revenue code.
X223 424 2400 SV202-1 010	Product or Service ID Qualifier	ID	2-2	R	N/A	ER, HC, HP, IV, WK	999	IK403 = 1: "Required Data Element Missing"	2400.SV202-1 must be present.
X223 424 2400 SV202-1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.SV202-1 must be "HP" or "HC".
X223 424 2400 SV202-2 010	Procedure Code	AN	1-48	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.SV202-2 must be present.
X223 424 2400 SV202-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 507: "HCPCS"	When 2400.SV202-1 = "HC", 2400.SV202-2 must be a valid HCPCS Code.
X223 424 2400 SV202-2 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 71 "Attending Physician"	If A0427, A0428 (with a QL modifier in SV202-3, SV202-4, SV202-5, or SV202-6), A0425, A0429, A0430, A0431, A0432, A0433, A0434, A0435, A0888, or A0436 (non-scheduled transportation claim) are the only codes present, 2310A.NM1 must not be present. Otherwise, 2310A.NM1 must be present.
X223 424 2400 SV202-2 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 513: "HIPPS Rate Code for services Rendered"	When 2400.SV202-1 = "HP", 2400.SV202-2 must be a valid HIPPS Code.
X223 424 2400 SV202-3 010	Procedure Modifier	AN	2-2	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered"	2400.SV202-3 must be a valid HCPCS modifier Code.
X223 424 2400 SV202-3 020	N/A	AN	2-2	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered"	The procedure code modifiers in SV202 must not be duplicated within the same detail service line.
X223 424 2400 SV202-4 005	Procedure Modifier	AN	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2400.SV202-4 is present, 2400.SV202-3 must be present.
X223 424 2400 SV202-4 010	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered"	2400.SV202-4 must be a valid HCPCS modifier Code.
X223 424 2400 SV202-5 005	Procedure Modifier	AN	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2400.SV202-5 is present, 2400.SV202-4 must be present.
X223 424 2400 SV202-5 010	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered"	2400.SV202-5 must be a valid HCPCS modifier Code.
X223 424 2400 SV202-6 005	Procedure Modifier	AN	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2400.SV202-6 is present, 2400.SV202-5 must be present.
X223 424 2400 SV202-6 010	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered"	2400.SV202-6 must be a valid HCPCS modifier Code.
X223 424 2400 SV202-7 020	Description	AN	1-80	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.SV202-7 must contain at least one non-space character.
X223 424 2400 SV202-7 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 306 Detailed description of service	2400.SV202-7 must be present. when 2400.SV202-2 contains a non-specific procedure code.
X223 424 2400 SV202-7 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.SV202-7 must be 1-80 characters.
X223 424 2400 SV202-7 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 306: "Detailed description of service"	N/A
X223 424 2400 SV202-7 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.SV202-7 must be populated with accepted AN characters.
X223 424 2400 SV203 010	Line Item Charge Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.SV203 must be present.
X223 424 2400 SV203 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.SV203 must be numeric.
X223 424 2400 SV203 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.SV203 must be <= 99,999,999.99.
X223 424 2400 SV203 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 693: "Amount must be greater than or equal to zero" CSC 583: "Line Item Charge Amount"	2400.SV203 must be >= 0.
X223 424 2400 SV203 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 583: "Line Item Charge Amount"	2400.SV203 is limited to 0, 1 or 2 decimal positions.
X223 424 2400 SV203 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 400: "Claim is out of balance: CSC 583:"Line Item Charge Amount" CSC 643: "Service Line Paid Amount"	SV203 must = the payer amount paid found in 2430 SVD02 and the sum of all line adjustments found in 2430 CAS Adjustment Amounts for each other payer occurrence.
X223 424 2400 SV204 010	Unit or Basis for Measurement Code	ID	2-2	R	N/A	DA, UN	999	IK403 = 1: "Required Data Element Missing"	2400.SV204 must be present.
X223 424 2400 SV204 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.SV204 must be valid values.
X223 424 2400 SV205 010	Service Unit Count	R	1-15	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.SV205 must be present.
X223 424 2400 SV205 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.SV205 must be numeric.
X223 424 2400 SV205 025	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.SV205 must be 1-8 digits and limited to 0, 1, 2, or 3 decimal positions.
X223 424 2400 SV205 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.SV205 must be >= 0 and <= 999,999.9 and 2400.SV205 is limited to 0 or 1 decimal position.
X223 424 2400 SV205 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 476: "Missing or invalid units of service"	N/A
X223 424 2400 SV206 010	Unit Rate	ID	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 424 2400 SV207 020	Monetary Amount	R	1-18	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.SV207 must be numeric.
X223 424 2400 SV207 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.SV207 must be <= 99,999,999.99.
X223 424 2400 SV207 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 693: "Amount must be greater than or equal to zero" CSC 596: "Non-covered Charge Amount"	2400.SV207 must be >= 0
X223 424 2400 SV207 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 596: "Non-covered Charge Amount"	2400.SV207 is limited to 0, 1 or 2 decimal positions.
X223 429 2400 PWK 010	LINE SUPPLEMENTAL INFORMATION	N/A	10	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only ten iterations of 2400.PWK are allowed.
X223 429 2400 PWK01 010	Attachment Report Type Code	ID	2-2	R	N/A	03, 04, 05, 06, 07, 08, 09, 10, 11, 13, 15, 21, A3, A4, AM, AS, B2, B3, B4, BR, BS, BT, CB, CK, CT, D2, DA, DB, DG, DJ, DS, EB, HC, HR, I5, IR, LA, M1, MT, NN, OB, OC, OD, OE, OX, OZ, P4, P5, PE, PN, PO, PQ, PY, PZ, RB, RR, RT, RX, SG, V5, XP	999	IK403 = 1: "Required Data Element Missing"	2400.PWK01 must be present.
X223 429 2400 PWK01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.PWK01 must be valid values.
X223 429 2400 PWK02 010	Attachment Transmission Code	ID	1-2	R	N/A	AA, BM, EL, EM, FT, FX	999	IK403 = 1: "Required Data Element Missing"	2400.PWK02 must be present.
X223 429 2400 PWK02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.PWK02 must be valid values.
X223 429 2400 PWK03 010	Report Copies Needed	N0	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 429 2400 PWK04 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 429 2400 PWK05 010	Identification Code Qualifier	ID	1-2	S	N/A	AC	999	IK403 = 2: "Conditional Required Data Element Missing"	When 2400.PWK05 is present, 2400.PWK02 must be "BM", "EL", "EM", "FX" or "FT" .
X223 429 2400 PWK05 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.PWK05 must be "AC".
X223 429 2400 PWK06 010	Identification Code	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	When 2400.PWK06 is present, 2400.PWK02 must be "BM", "EL", "EM", "FX" or "FT" .
X223 429 2400 PWK06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.PWK06 must contain at least two non-space characters.
X223 429 2400 PWK06 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 4: "Data Element Too Short" IK403 = 5: "Data Element Too Long"	2400.PWK06 must be 2-50 characters.
X223 429 2400 PWK06 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 489: "Attachment Control Number"	N/A
X223 429 2400 PWK06 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.PWK06 must be populated with accepted AN characters.
X223 429 2400 PWK07 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 429 2400 PWK08 010	ACTIONS INDICATED	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 429 2400 PWK09 010	Request Category Code	ID	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 433 2400 DTP 020	SERVICE LINE DATE	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.DTP with DTP01 = "472" is allowed.
X223 433 2400 DTP01 010	Date Time Qualifier	ID	3-3	R	N/A	472	999	IK403 = 1: "Required Data Element Missing"	2400.DTP01 must be "472".
X223 433 2400 DTP02 010	Date Time Period Format Qualifier	ID	2-3	R	N/A	D8, RD8	999	IK403 = 1: "Required Data Element Missing"	2400.DTP02 must be present.
X223 433 2400 DTP02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.DTP02 must be valid values.
X223 433 2400 DTP03 010	Service Date	AN	1-35	R	N/A	CYYMMDD, CCYYMMDD-CCYYMMDD	999	IK403 = 1: "Required Data Element Missing"	2400.DTP03 must be present.
X223 433 2400 DTP03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	If 2400.DTP02 = "D8" then 2400.DTP03 must be a valid date in CCYYMMDD format .
X223 433 2400 DTP03 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	If 2400.DTP02 = "RD8*" then 2400.DTP03 must be a valid date in CCYYMMDD-CCYYMMDD format.
X223 433 2400 DTP03 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 510: "Future date" CSC 187: "Date(s) of service"	2400.DPT03 may not be a future date, except for type of bill 0322 after 1/1/2021.
X223 435 2400 REF 010	LINE ITEM CONTROL NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.REF with REF01 = "6R" is allowed.
X223 435 2400 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	6R	999	IK403 = 1: "Required Data Element Missing"	2400.REF01 must be present.
X223 435 2400 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.REF01 must be "6R".
X223 435 2400 REF02 010	Line Item Control Number	AN	1-30	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.REF02 must be present.
X223 435 2400 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.REF02 must contain at least one non-space character.
X223 435 2400 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.REF02 must be 1-30 characters.
X223 435 2400 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 584: "Line Item Control Number"	N/A
X223 435 2400 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.REF02 must be populated with accepted AN characters.
X223 435 2400 REF02 070	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 584: "Line Item Control Number"	2400.REF02 must be unique within a single iteration of 2300.CLM01.
X223 435 2400 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 435 2400 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 437 2400 REF 010	REPRICED LINE ITEM REFERENCE NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.REF with REF01 = "9B" is allowed.
X223 437 2400 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	9B	999	IK403 = 1: "Required Data Element Missing"	2400.REF01 must be present.
X223 437 2400 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.REF01 must be "9B".
X223 437 2400 REF02 010	Repriced Line Item Reference Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.REF02 must be present.
X223 437 2400 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.REF02 must contain at least one non-space character.
X223 437 2400 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.REF02 must be 1-50 characters.
X223 437 2400 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 636: "Repriced Line Item Reference Number"	N/A
X223 437 2400 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.REF02 must be populated with accepted AN characters.
X223 437 2400 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 437 2400 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 438 2400 REF 010	ADJUSTED REPRICED LINE ITEM REFERENCE NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.REF with REF01 = "9D" is allowed.
X223 438 2400 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	9D	999	IK403 = 1: "Required Data Element Missing"	2400.REF01 must be present.
X223 438 2400 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.REF01 must be "9D".
X223 438 2400 REF02 010	Adjusted Repriced Line Item Reference Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.REF02 must be present.
X223 438 2400 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.REF02 must contain at least one non-space character.
X223 438 2400 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.REF02 must be 1-50 characters.
X223 438 2400 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 518: "Adjusted Repriced Line item Reference Number"	N/A
X223 438 2400 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.REF02 must be populated with accepted AN characters.
X223 438 2400 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 438 2400 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 439 2400 AMT 010	SERVICE TAX AMOUNT	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.AMT with AMT01 = "GT" is allowed.
X223 439 2400 AMT01 010	Amount Qualifier Code	ID	1-3	R	N/A	GT	999	IK403 = 1: "Required Data Element Missing"	2400.AMT01 must be present.
X223 439 2400 AMT01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.AMT01 must be "GT".
X223 439 2400 AMT02 010	Service Tax Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.AMT02 must be present.
X223 439 2400 AMT02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.AMT02 must be numeric.
X223 439 2400 AMT02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.AMT02 must be >= 0 and <= 99,999,999.99.
X223 439 2400 AMT02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 645: "Service Tax Amount"	N/A
X223 439 2400 AMT02 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 645: "Service Tax Amount"	2400.AMT02 is limited to 0, 1 or 2 decimal positions.
X223 439 2400 AMT03 010	Credit/Debit Flag Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 440 2400 AMT 010	FACILITY TAX AMOUNT	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.AMT with AMT01 = "N8" is allowed.
X223 440 2400 AMT01 010	Amount Qualifier Code	ID	1-3	R	N/A	N8	999	IK403 = 1: "Required Data Element Missing"	2400.AMT01 must be present.
X223 440 2400 AMT01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.AMT01 must be "N8".
X223 440 2400 AMT02 010	Facility Tax Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.AMT02 must be present.
X223 440 2400 AMT02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.AMT02 must be numeric.
X223 440 2400 AMT02 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 693: "Amount must be greater than or equal to zero" CSC 563: "Entity's Tax Amount" EIC: FA Facility	2400.AMT02 must be >= 0.
X223 440 2400 AMT02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.AMT02 must be <= 99,999,999.99.
X223 440 2400 AMT02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 563: "Entity's Tax Amount" EIC: FA Facility	N/A
X223 440 2400 AMT02 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 563: "Entity's Tax Amount" EIC: FA Facility	2400.AMT02 is limited to 0, 1 or 2 decimal positions.
X223 440 2400 AMT03 010	Credit/Debit Flag Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 441 2400 NTE 010	THIRD PARTY ORGANIZATION NOTES	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2400.NTE is allowed.
X223 441 2400 NTE01 010	Note Reference Code	ID	3-3	R	N/A	TPO	999	IK403 = 1: "Required Data Element Missing"	2400.NTE01 must be present.
X223 441 2400 NTE01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.NTE01 must be "TPO".
X223 441 2400 NTE02 010	Line Note Text	AN	1-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2400.NTE02 must be present.
X223 441 2400 NTE02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.NTE02 must contain at least one non-space character.
X223 441 2400 NTE02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.NTE02 must be 1-80 characters.
X223 441 2400 NTE02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 586: "Line Note Text"	N/A
X223 441 2400 NTE02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2400.NTE02 must be populated with accepted AN characters.
X223 442 2400 HCP 015	LINE PRICING/REPRICING INFORMATION	N/A	1	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 64: "Re-pricing information."	Segment must not be present.
X223 449 2410 LIN 010	DRUG IDENTIFICATION	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2410.LIN is allowed.
X223 449 2410 LIN01 010	Assigned Identification	AN	1-20	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN02 010	Product or Service ID Qualifier	ID	2-2	R	N/A	N4	999	IK403 = 1: "Required Data Element Missing"	2410.LIN02 must be present.
X223 449 2410 LIN02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2410.LIN02 must be "N4".
X223 449 2410 LIN03 010	National Drug Code	AN	1-48	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2410.LIN03 must be present.
X223 449 2410 LIN03 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 218: "NDC Number"	2410.LIN03 must be 11 bytes alpha-numeric
X223 449 2410 LIN03 020 Edit Deactivated	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 218: "NDC Number"	2410.LIN03 must be a valid NDC code.
X223 449 2410 LIN04 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN05 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN06 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN07 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN08 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN09 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN10 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN11 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN12 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN13 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN14 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN15 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN16 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN17 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN18 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN19 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN20 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN21 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN22 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN23 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN24 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN25 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN26 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN27 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN28 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN29 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN30 010	Product/Service ID Qualifier	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 449 2410 LIN31 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP 010	DRUG QUANTITY	N/A	1	R	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2410.LIN is present, 2410.CTP must be present.
X223 452 2410 CTP 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2410.CTP is allowed.
X223 452 2410 CTP01 010	Class of Trade Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP02 010	Price Identifier Code	ID	3-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP03 010	Unit Price	R	1-17	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP04 010	National Drug Unit Count	R	1-15	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2410.CTP04 must be present.
X223 452 2410 CTP04 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2410.CTP04 must be > 0 and <= 9,999,999.999.
X223 452 2410 CTP04 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 216: "Drug information"	2410.CTP04 is limited to 3 decimal positions.
X223 452 2410 CTP05-1 010	Unit or Basis For Measurement Code	ID	2-2	R	N/A	F2, GR, ME, ML, UN	999	IK403 = 1: "Required Data Element Missing"	2410.CTP05-1 must be present.
X223 452 2410 CTP05-1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2410.CTP05-1 must be valid values.
X223 452 2410 CTP05-2 010	Exponent	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-3 010	Multiplier	R	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-4 010	Unit or Basis For Measurement Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-5 010	Exponent	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-6 010	Multiplier	R	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-7 010	Unit or Basis For Measurement Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-8 010	Exponent	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-9 010	Multiplier	R	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-10 010	Unit or Basis For Measurement Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-11 010	Exponent	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-12 010	Multiplier	R	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-13 010	Unit or Basis For Measurement Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-14 010	Exponent	R	1-15	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP05-15 010	Multiplier	R	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP06 010	Price Multiplier Qualifier	ID	3-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP07 010	Multiplier	R	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP08 010	Monetary Amount	R	1-18	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP09 010	Basis of Unit Price Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP10 010	Condition Value	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 452 2410 CTP11 010	Multiple Price Quantity	N0	1-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 454 2410 REF 020	PRESCRIPTION OR COMPOUND DRUG ASSOCIATION NUMBER	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2410.REF is allowed.
X223 454 2410 REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	VY, XZ	999	IK403 = 1: "Required Data Element Missing"	2410.REF01 must be present.
X223 454 2410 REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2410.REF01 must be valid values.
X223 454 2410 REF02 010	Prescription Number	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2410.REF02 must be present.
X223 454 2410 REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2410.REF02 must contain at least one non-space character.
X223 454 2410 REF02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2410.REF02 must be 1-50 characters.
X223 454 2410 REF02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 219: "Prescription number"	N/A
X223 454 2410 REF02 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2410.REF02 must be populated with accepted AN characters.
X223 454 2410 REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 454 2410 REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 456 2420A NM1 010	OPERATING PHYSICIAN NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2420A.NM1 is allowed.
X223 456 2420A NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2420A.NM1 is present, 2310B.NM1 must be present.
X223 456 2420A NM101 010	Entity Identifier Code	ID	2-3	R	N/A	72	999	IK304 = 2: "Unexpected segment"	2420A.NM101 must be present and a valid value.
X223 456 2420A NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2420A.NM102 must be present.
X223 456 2420A NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2420A.NM102 must be "1".
X223 456 2420A NM103 010	Last Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2420A.NM103 must be present.
X223 456 2420A NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420A.NM103 must be 1-60 characters.
X223 456 2420A NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: 72 "Operating Physician"	N/A
X223 456 2420A NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420A.NM103 must be populated with accepted AN characters.
X223 456 2420A NM103 060	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420A.NM103 must contain at least one non-space character.
X223 456 2420A NM104 010	First Name	AN	1-35	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420A.NM104 must contain at least one non-space character.
X223 456 2420A NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420A.NM104 must be 1-35 characters.
X223 456 2420A NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: 72 "Operating Physician"	N/A
X223 456 2420A NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420A.NM104 must be populated with accepted AN characters.
X223 456 2420A NM105 010	Middle Name	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420A.NM105 must contain at least one non-space character.
X223 456 2420A NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420A.NM105 must be 1-25 characters.
X223 456 2420A NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: 72 "Operating Physician"	N/A
X223 456 2420A NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420A.NM105 must be populated with accepted AN characters.
X223 456 2420A NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: 72 "Operating Physician"	The first position of 2420A.NM105 must be alphabetic (A...Z).
X223 456 2420A NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 456 2420A NM107 010	Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420A.NM107 must contain at least one non-space character.
X223 456 2420A NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420A.NM107 must be 1-10 characters.
X223 456 2420A NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: 72 "Operating Physician"	N/A
X223 456 2420A NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420A.NM107 must be populated with accepted AN characters.
X223 456 2420A NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2420A.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 456 2420A NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2420A.NM108 must be present.
X223 456 2420A NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2420A.NM108 must be "XX".
X223 456 2420A NM109 010	Identifier	AN	2-80	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2420A.NM109 must be valid according to the NPI algorithm.
X223 456 2420A NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	The first position of 2420A.NM109 must be a "1".
X223 456 2420A NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 456 2420A NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 456 2420A NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 459 2420A REF 010	OPERATING PHYSICIAN SECONDARY IDENTIFICATION	N/A	20	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2420A.NM109 is not present, 2420A.REF with REF01 = "1G" must be present.
X223 459 2420A REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: Entity's Additional/Secondary Identifier EIC: 72 "Operating Physician"	Only 1 iteration of 2420A.REF with REF01 = "1G" is allowed.
X223 459 2420A REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2420A.REF must not be present.
X223 459 2420A REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	0B, 1G, G2, LU	999	IK403 = 1: "Required Data Element Missing"	2420A.REF01 must be present.
X223 459 2420A REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: Entity's Additional/Secondary Identifier EIC: 72 "Operating Physician"	2420A.REF01 must be "1G".
X223 459 2420A REF02 010	Reference Identifier	AN	1-50	R	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" EIC: 72 "Operating Physician"	2420A.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 459 2420A REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 459 2420A REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 461 2420B NM1 010	OTHER OPERATING PHYSICIAN NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2420B.NM1 is allowed.
X223 461 2420B NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2420B.NM1 is present, 2310C.NM1 must be present.
X223 461 2420B NM101 010	Entity Identifier Code	ID	2-3	R	N/A	ZZ	999	IK304 = 2: "Unexpected segment"	2420B.NM101 must be present and a valid value.
X223 461 2420B NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2420B.NM102 must be present.
X223 461 2420B NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2420B.NM102 must be "1".
X223 461 2420B NM103 010	Last Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2420B.NM103 must be present.
X223 461 2420B NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420B.NM103 must contain at least one non-space character.
X223 461 2420B NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420B.NM103 must be 1-60 characters.
X223 461 2420B NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: 72 "Operating Physician"	N/A
X223 461 2420B NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420B.NM103 must be populated with accepted AN characters.
X223 461 2420B NM104 010	First Name	AN	1-35	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420B.NM104 must contain at least one non-space character.
X223 461 2420B NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420B.NM104 must be 1-35 characters.
X223 461 2420B NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: 72 "Operating Physician"	N/A
X223 461 2420B NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420B.NM104 must be populated with accepted AN characters.
X223 461 2420B NM105 010	Middle Name	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420B.NM105 must contain at least one non-space character.
X223 461 2420B NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420B.NM105 must be 1-25 characters.
X223 461 2420B NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: 72 "Operating Physician"	N/A
X223 461 2420B NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420B.NM105 must be populated with accepted AN characters.
X223 461 2420B NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: 72 "Operating Physician"	The first position of 2420B.NM105 must be alphabetic (A...Z).
X223 461 2420B NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 461 2420B NM107 010	Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420B.NM107 must contain at least one non-space character.
X223 461 2420B NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420B.NM107 must be 1-10 characters.
X223 461 2420B NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: 72 "Operating Physician"	N/A
X223 461 2420B NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420B.NM107 must be populated with accepted AN characters.
X223 461 2420B NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2420B.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 461 2420B NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2420B.NM108 must be present.
X223 461 2420B NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2420B.NM108 must be "XX".
X223 461 2420B NM109 010	Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2420B.NM109 must be present when 2420B.NM108 is present.
X223 461 2420B NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	2420B.NM109 must be valid according to the NPI algorithm.
X223 461 2420B NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 72 "Operating Physician"	The first position of 2420B.NM109 must be a "1".
X223 461 2420B NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 461 2420B NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 461 2420B NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 464 2420B REF 010	OTHER OPERATING PHYSICIAN SECONDARY IDENTIFICATION	N/A	20	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2420B.NM109 is not present, then 2420B.REF with REF01 = "1G" must be present.
X223 464 2420B REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: Entity's Additional/Secondary Identifier EIC: 72 "Operating Physician"	Only 1 iteration of 2420B.REF with REF01 = "1G" is allowed.
X223 464 2420B REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2420B.REF must not be present.
X223 464 2420B REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	0B, 1G, G2, LU	999	IK403 = 1: "Required Data Element Missing"	2420B.REF01 must be present.
X223 464 2420B REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: Entity's Additional/Secondary Identifier EIC: 72 "Operating Physician"	2420B.REF01 must be "1G".
X223 464 2420B REF02 010	Reference Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2420B.REF02 must be present.
X223 464 2420B REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" EIC: 72 "Operating Physician"	2420B.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 464 2420B REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 464 2420B REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 466 2420C NM1 010	RENDERING PROVIDER NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2420C.NM1 is allowed.
X223 466 2420C NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2420C.NM1 is present, 2310A.NM1 must be present.
X223 466 2420C NM101 010	Entity Identifier Code	ID	2-3	R	N/A	82	999	IK304 = 2: "Unexpected segment"	2420C.NM101 must be present and a valid value.
X223 466 2420C NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2420C.NM102 must be present.
X223 466 2420C NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2420C.NM102 must be "1".
X223 466 2420C NM103 010	Rendering Provider Last or Organization Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2420C.NM103 must be present.
X223 466 2420C NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420C.NM103 must contain at least one non-space character.
X223 466 2420C NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420C.NM103 must be 1-60 characters.
X223 466 2420C NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: 82 "Rendering Provider"	N/A
X223 466 2420C NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420C.NM103 must be populated with accepted AN characters.
X223 466 2420C NM104 010	Rendering Provider First Name	AN	1-35	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420C.NM104 must contain at least one non-space character.
X223 466 2420C NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420C.NM104 must be 1-35 characters.
X223 466 2420C NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: 82 "Rendering Provider"	N/A
X223 466 2420C NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420C.NM104 must be populated with accepted AN characters.
X223 466 2420C NM105 010	Rendering Provider Middle Name	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420C.NM105 must contain at least one non-space character.
X223 466 2420C NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420C.NM105 must be 1-25 characters.
X223 466 2420C NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: 82 "Rendering Provider"	N/A
X223 466 2420C NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420C.NM105 must be populated with accepted AN characters.
X223 466 2420C NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: 82 "Rendering Provider"	The first position of 2420C.NM105 must be alphabetic (A...Z).
X223 466 2420C NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 466 2420C NM107 005	Rendering Provider Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420C.NM107 must contain at least one non-space character.
X223 466 2420C NM107 010	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420C.NM107 must be 1-10 characters.
X223 466 2420C NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: 82 "Rendering Provider"	N/A
X223 466 2420C NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420C.NM107 must be populated with accepted AN characters.
X223 466 2420C NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 82 "Rendering Provider"	2420C.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 466 2420C NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 82 "Rendering Provider"	2420C.NM108 must be present.
X223 466 2420C NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2420C.NM108 must be "XX".
X223 466 2420C NM109 010	Rendering Provider Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2420C.NM109 must be present when 2420C.NM108 is present.
X223 466 2420C NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 82 "Rendering Provider"	2420C.NM109 must be valid according to the NPI algorithm.
X223 466 2420C NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: 82 "Rendering Provider"	The first position of 2420C.NM109 must be a "1".
X223 466 2420C NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 466 2420C NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 466 2420C NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 469 2420C REF 010	RENDERING PROVIDER SECONDARY IDENTIFICATION	N/A	20	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2420C.NM109 is not present, 2420C.REF with REF01 = "1G" must be present.
X223 469 2420C REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 82 "Rendering Provider"	Only 1 iteration of 2420C.REF with REF01 = "1G" is allowed.
X223 469 2420C REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2420C.REF must not be present.
X223 469 2420C REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	OB, 1G, G2, LU	999	IK403 = 1: "Required Data Element Missing"	2420C.REF01 must be present.
X223 469 2420C REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: 82 "Rendering Provider"	2420C.REF01 must be "1G".
X223 469 2420C REF02 010	Rendering Provider Secondary Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2420C.REF02 must be present.
X223 469 2420C REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" CSC 560: "Entity's Additional/Secondary Identifier" EIC: 82 "Rendering Provider"	2420C.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 469 2420C REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 469 2420C REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 471 2420D NM1 010	REFERRING PROVIDER NAME	N/A	1	S	1	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only one iteration of 2420D.NM1 is allowed.
X223 471 2420D NM1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2420D.NM1 is allowed.
X223 471 2420D NM101 010	Entity Identifier Code	ID	2-3	R	N/A	DN	999	IK304 = 2: "Unexpected segment"	2420D.NM101 must be present and a valid value.
X223 471 2420D NM102 010	Entity Type Qualifier	ID	1-1	R	N/A	1	999	IK403 = 1: "Required Data Element Missing"	2420D.NM102 must be present.
X223 471 2420D NM102 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2420D.NM102 must be "1".
X223 471 2420D NM103 010	Referring Provider Last Name	AN	1-60	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2420D.NM103 must be present.
X223 471 2420D NM103 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420D.NM103 must contain at least one non-space character.
X223 471 2420D NM103 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420D.NM103 must be 1-60 characters.
X223 471 2420D NM103 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 504: "Entity's Last Name" EIC: DN "Referring Provider"	N/A
X223 471 2420D NM103 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420D.NM103 must be populated with accepted AN characters.
X223 471 2420D NM104 010	Referring Provider First Name	AN	1-35	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420D.NM104 must contain at least one non-space character.
X223 471 2420D NM104 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420D.NM104 must be 1-35 characters.
X223 471 2420D NM104 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 505: "Entity's First Name" EIC: DN "Referring Provider"	N/A
X223 471 2420D NM104 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420D.NM104 must be populated with accepted AN characters.
X223 471 2420D NM105 010	Referring Provider Middle Name or Initial	AN	1-25	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420D.NM105 must contain at least one non-space character.
X223 471 2420D NM105 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420D.NM105 must be 1-25 characters.
X223 471 2420D NM105 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 514: "Entity's Middle Name" EIC: DN "Referring Provider"	N/A
X223 471 2420D NM105 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420D.NM105 must be populated with accepted AN characters.
X223 471 2420D NM105 045	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 514: "Entity's Middle Name" EIC: DN "Referring Provider"	The first position of 2420D.NM105 must be alphabetic (A...Z).
X223 471 2420D NM106 010	Name Prefix	AN	1-10	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 471 2420D NM107 010	Referring Provider Name Suffix	AN	1-10	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420D.NM107 must contain at least one non-space character.
X223 471 2420D NM107 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2420D.NM107 must be 1-10 characters.
X223 471 2420D NM107 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 125: "Entity's Name" EIC: DN "Referring Provider"	N/A
X223 471 2420D NM107 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2420D.NM107 must be populated with accepted AN characters.
X223 471 2420D NM108 010	Identification Code Qualifier	ID	1-2	S	N/A	XX	277	CSCC A8: "Acknowledgement / Rejected for relational field in error" CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: DN "Referring Provider"	2420D.NM108 must not be present when 2300.REF with REF01 = "P4" and REF02 is a valid VA identifier.
X223 471 2420D NM108 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A6: "Acknowledgement/Rejected for Missing Information..." CSC 745: "Identifier Qualifier" CSC 562: "Entity's National Provider Identifier (NPI)" EIC: DN "Referring Provider"	2420D.NM108 must be present.
X223 471 2420D NM108 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2420D.NM108 must be "XX".
X223 471 2420D NM109 010	Referring Provider Identifier	AN	2-80	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2420D.NM109 must be present when 2420D.NM108 is present.
X223 471 2420D NM109 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: DN "Referring Provider"	2420D.NM109 must be valid according to the NPI algorithm.
X223 471 2420D NM109 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 562: "Entity's National Provider Identifier (NPI)" EIC: DN "Referring Provider"	The first position of 2420D.NM109 must be a "1".
X223 471 2420D NM109 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	2420D.NM109 must not = 2310A.NM109.
X223 471 2420D NM109 060	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	2420D.NM109 must not = 2310F.NM109.
X223 471 2420D NM110 010	Entity Relationship Code	ID	2-2	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 471 2420D NM111 010	Entity Identifier Code	ID	2-3	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 471 2420D NM112 010	Name Last or Organization Name	AN	1-60	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 474 2420D REF 010	REFERRING PROVIDER SECONDARY IDENTIFICATION	N/A	20	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	If 2420D.NM109 is not present, 2420D.REF with REF01 = "1G" must be present.
X223 474 2420D REF 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: DN "Referring Provider"	Only 1 iteration of 2420D.REF with REF01 = "1G" is allowed.
X223 474 2420D REF 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present"	2420D.REF must not be present.
X223 474 2420D REF01 010	Reference Identification Qualifier	ID	2-3	R	N/A	OB, 1G, G2	999	IK403 = 1: "Required Data Element Missing"	2420D.REF01 must be present.
X223 474 2420D REF01 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 732: "Information submitted inconsistent with billing guidelines." CSC 560: "Entity's Additional/Secondary Identifier." EIC: DN "Referring Provider"	2420E.REF01 must be"1G".
X223 474 2420D REF02 010	Referring Provider Secondary Identifier	AN	1-50	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2420D.REF02 must be present.
X223 474 2420D REF02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 133: "Entity's UPIN" CSC 560: "Entity's Additional/Secondary Identifier" EIC: DN "Referring Provider"	2420D.REF02 must be in format ANNNNN or AAANNN (where A is an alpha character and N is a numeric digit).
X223 474 2420D REF03 010	Description	AN	1-80	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 474 2420D REF04 010	REFERENCE IDENTIFIER	N/A	N/A	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 476 2430 010	LINE ADJUDICATION LOOP	N/A	N/A	N/A	15	N/A	999	IK304 = 4: "Loop Occurs Over Maximum Times"	Only 15 iterations of the 2430 loop are allowed.
X223 476 2430 SVD 010	LINE ADJUDICATION INFORMATION	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2430.SVD is allowed.
X223 476 2430 SVD01 010	Payer Identifier	AN	2-80	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2430.SVD01 must be present.
X223 476 2430 SVD01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	2430.SVD01 must = 2330B.NM109 (for the same payer).
X223 476 2430 SVD02 010	Service Line Paid Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2430.SVD02 must be present.
X223 476 2430 SVD02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.SVD02 must be numeric.
X223 476 2430 SVD02 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.SVD02 must be >= 0 and <= 99,999,999.99.
X223 476 2430 SVD02 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system"	N/A
X223 476 2430 SVD02 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 643: "Service Line Paid Amount" CSC 697: "Invalid Decimal Precision"	2430.SVD02 is limited to 0, 1 or 2 decimal positions.
X223 476 2430 SVD03-1 010	Product or Service ID Qualifier	ID	2-2	R	N/A	ER, HC, HP, IV, WK	999	IK403 = 1: "Required Data Element Missing"	2430.SVD03-1 must be present.
X223 476 2430 SVD03-1 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2400.SVD03-1 must be "HP" or "HC".
X223 476 2430 SVD03-2 010	Procedure Code	AN	1-48	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2430.SVD03-2 must be present.
X223 476 2430 SVD03-2 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 507: "HCPCS" CSC 710: "Line Adjudication Information"	When 2430.SVD03-1 = "HC", 2430.SVD03-2 must be a valid HCPCS Code.
X223 476 2430 SVD03-2 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 513: "HIPPS Rate Code for services Rendered" CSC 710: "Line Adjudication Information"	When 2430.SVD03-1 = "HP", 2430.SVD03-2 must be a valid HIPPS Skilled Nursing Facility Rate Code
X223 476 2430 SVD03-3 010	Procedure Modifier	AN	2-2	S	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered" CSC 710: "Line Adjudication Information"	2430.SVD03-3 must be valid procedure modifier.
X223 476 2430 SVD03-3 020	N/A	AN	2-2	S	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered"	The procedure code modifiers in SVD03 must not be duplicated within the same detail service line.
X223 476 2430 SVD03-4 010	Procedure Modifier	AN	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2430.SVD03-4 is present, 2430.SVD03-3 must be present.
X223 476 2430 SVD03-4 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered" CSC 710: "Line Adjudication Information"	2430.SVD03-4 must be valid procedure modifier.
X223 476 2430 SVD03-5 010	Procedure Modifier	AN	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2430.SVD03-5 is present, 2430.SVD03-4 must be present.
X223 476 2430 SVD03-5 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered" CSC 710: "Line Adjudication Information"	2430.SVD03-5 must be valid procedure modifier.
X223 476 2430 SVD03-6 010	Procedure Modifier	AN	2-2	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	2430.SVD03-6 is present, 2430.SVD03-5 must be present.
X223 476 2430 SVD03-6 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 453: "Procedure Code Modifier(s) for Service(s) Rendered" CSC 710: "Line Adjudication Information"	2430.SVD03-6 must be valid procedure modifier.
X223 476 2430 SVD03-7 010	Procedure Code Description	AN	1-80	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.SVD03-7 must contain at least one non-space character.
X223 476 2430 SVD03-7 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.SVD03-7 must be 1-80 characters.
X223 476 2430 SVD03-7 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 306: "Detailed description of service" CSC 710: "Line Adjudication Information"	N/A
X223 476 2430 SVD03-7 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.SVD03-7 must be populated with accepted AN characters.
X223 476 2430 SVD03-8 010	Product/Service ID	AN	1-48	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223A2 26 2430 SVD04 010	Product or Service ID	AN	1-48	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2430.SVD04 must be present.
X223A2 26 2430 SVD04 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 455: "Revenue code for services rendered"	2430.SVD04 must be a valid revenue code.
X223 476 2430 SVD05 010	Paid Service Unit Count	R	1-15	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2430.SVD05 must be present.
X223A2 26 2430 SVD05 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.SVD05 must be numeric.
X223A2 26 2430 SVD05 025	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2400.SVD05 must be 1-8 digits and limited to 0, 1, 2, or 3 decimal positions.
X223 476 2430 SVD05 065	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.SVD05 must be >=0 and <= 999,999.9.
X223 476 2430 SVD05 070	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 608: "Paid Service Unit Count" CSC 710: "Line Adjudication Information"	N/A
X223 476 2430 SVD06 010	Bundled or Unbundled Line Number	N0	1-6	S	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.SVD06 must be numeric.
X223 476 2430 SVD06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.SVD06 must be a integer (no decimals).
X223 476 2430 SVD06 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.SVD06 must 1 - 6 digits.
X223 476 2430 SVD06 050	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system"	N/A
X223 480 2430 CAS 010	LINE ADJUSTMENT	N/A	5	S	N/A	N/A	999	IK304 = I9: "Implementation Dependent "Not Used" Segment Present" OR IK304 = 2: "Unexpected Segment"	If 2430.CAS is present, 2430.SVD must be present.
X223 480 2430 CAS 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only 5 iterations of 2430.CAS are allowed.
X223 480 2430 CAS 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement/Rejected for Invalid Information..." CSC 41: Special handling required at payer site CSC 286: Other payer's Explanation of Benefits/payment information CSC 732: Information submitted inconsistent with billing guidelines	If 2000B.SBR01 = "P" then 2430.CAS must not be present.
X223 480 2430 CAS01 010	Claim Adjustment Group Code	ID	1-2	R	N/A	CO, CR, OA, PI, PR	999	IK403 = 1: "Required Data Element Missing"	2430.CAS01 must be present.
X223 480 2430 CAS01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2430.CAS01 must be valid values.
X223 480 2430 CAS01 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 521: "Adjustment Reason Code"	If 2430 CAS01 = "CR", "OA", or "PI": then 2430 CAS02 must not = 45, 2430.CAS05 must not = 45, 2430.CAS08 must not = 45, 2430.CAS11 must not = 45, 2430.CAS14 must not = 45, or 2320.CAS17 must not = 45.
X223 480 2430 CAS02 010	Adjustment Reason Code	ID	1-5	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2430.CAS02 must be present.
X223 480 2430 CAS02 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	2430.CAS02 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 480 2430 CAS03 010	Adjustment Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2430.CAS03 must be present.
X223 480 2430 CAS03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.CAS03 must be numeric.
X223 480 2430 CAS03 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS03 is limited to 0, 1 or 2 decimal positions.
X223 480 2430 CAS03 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS03 must be >= -99,999,999.99 and <= 99,999,999.99
X223 480 2430 CAS03 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS03 065	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS03 must not = 0.
X223 480 2430 CAS04 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS04 must be 1-15 digits.
X223 480 2430 CAS04 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS04 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2430.CAS04 must not = 0.
X223 480 2430 CAS05 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS05 is present, 2430.CAS02 must be present.
X223 480 2430 CAS05 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	2430.CAS05 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 480 2430 CAS06 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS06 is present, 2430.CAS05 must be present.
X223 480 2430 CAS06 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.CAS06 must be numeric.
X223 480 2430 CAS06 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2320.CAS06 is limited to 0, 1 or 2 decimal positions.
X223 480 2430 CAS06 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS06 must be >= -99,999,999.99 and <= 99,999,999.99
X223 480 2430 CAS06 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS06 065	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS06 must not = 0.
X223 480 2430 CAS07 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS07 is present, 2430.CAS05 must be present.
X223 480 2430 CAS07 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2320.CAS07 must be 1-15 digits.
X223 480 2430 CAS07 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS07 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2430.CAS07 must not = 0.
X223 480 2430 CAS08 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS08 is present, 2430.CAS05 must be present.
X223 480 2430 CAS08 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	2430.CAS08 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 480 2430 CAS09 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS09 is present, 2430.CAS08 must be present.
X223 480 2430 CAS09 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.CAS09 must be numeric.
X223 480 2430 CAS09 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS09 is limited to 0, 1 or 2 decimal positions.
X223 480 2430 CAS09 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS09 must be >= -99,999,999.99 and <= 99,999,999.99
X223 480 2430 CAS09 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS09 065	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS09 must not = 0.
X223 480 2430 CAS10 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS10 is present, 2430.CAS08 must be present.
X223 480 2430 CAS10 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS10 must be 1-15 digits.
X223 480 2430 CAS10 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS10 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2430.CAS10 must not = 0.
X223 480 2430 CAS11 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2320.CAS11 is present, 2320.CAS08 must be present.
X223 480 2430 CAS11 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	2430.CAS11 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 480 2430 CAS12 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS12 is present, 2430.CAS11 must be present.
X223 480 2430 CAS12 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.CAS12 must be numeric.
X223 480 2430 CAS12 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS12 is limited to 0, 1 or 2 decimal positions.
X223 480 2430 CAS12 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS12 must be >= -99,999,999.99 and <= 99,999,999.99
X223 480 2430 CAS12 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS12 065	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS12 must not = 0.
X223 480 2430 CAS13 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS13 is present, 2430.CAS11 must be present.
X223 480 2430 CAS13 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS13 must be 1-15 digits.
X223 480 2430 CAS13 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS13 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2430.CAS13 must not = 0.
X223 480 2430 CAS14 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS14 is present, 2430.CAS11 must be present.
X223 480 2430 CAS14 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	2430.CAS14 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 480 2430 CAS15 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS15 is present, 2430.CAS14 must be present.
X223 480 2430 CAS15 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.CAS15 must be numeric.
X223 480 2430 CAS15 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS15 is limited to 0, 1 or 2 decimal positions.
X223 480 2430 CAS15 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS15 must be >= -99,999,999.99 and <= 99,999,999.99
X223 480 2430 CAS15 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS15 065	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS15 must not = 0.
X223 480 2430 CAS16 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS16 is present, 2430.CAS14 must be present.
X223 480 2430 CAS16 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS16 must be 1-15 digits.
X223 480 2430 CAS16 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS16 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2430.CAS16 must not = 0.
X223 480 2430 CAS17 010	Adjustment Reason Code	ID	1-5	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS17 is present, 2430.CAS14 must be present.
X223 480 2430 CAS17 020	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field in error." CSC 521: Adjustment Reason Code CSC 516: Adjudication or Payment Date EIC: GB "Other Insured"	2430.CAS17 must be a valid Claim Adjustment Reason Code on the date in 2430.DTP03 when DTP01 = "573".
X223 480 2430 CAS18 010	Adjustment Amount	R	1-18	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS18 is present, 2430.CAS17 must be present.
X223 480 2430 CAS18 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430.CAS18 must be numeric.
X223 480 2430 CAS18 040	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 697: "Invalid Decimal Precision" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS18 is limited to 0, 1 or 2 decimal positions.
X223 480 2430 CAS18 050	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS18 must be >= -99,999,999.99 and <= 99,999,999.99
X223 480 2430 CAS18 060	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS18 065	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 519: "Adjustment Amount" EIC: GB "Other Insured"	2430.CAS18 must not = 0.
X223 480 2430 CAS19 010	Adjustment Quantity	R	1-15	S	N/A	N/A	999	IK403 = 2: "Conditional Required Data Element Missing"	If 2430.CAS19 is present, 2430.CAS17 must be present.
X223 480 2430 CAS19 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.CAS19 must be 1-15 digits.
X223 480 2430 CAS19 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	N/A
X223 480 2430 CAS19 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 694: "Amount must not be equal to zero" CSC 520: "Adjustment Quantity" EIC: GB "Other Insured"	2430.CAS19 must not = 0.
X223 486 2430 DTP 010	LINE CHECK OR REMITTANCE DATE	N/A	1	R	N/A	N/A	999	IK304 = I6: "Implementation Dependent Segment Missing"	If 2430.SVD is present, 2430.DTP must be present.
X223 486 2430 DTP 015	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = I12: "Implementation Pattern Match Failure"	Per payer, if 2330B.DTP is present, 2430.DTP must not be present.
X223 486 2430 DTP 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Per payer, only one iteration of 2430.DTP is allowed.
X223 486 2430 DTP01 010	Date /Time Qualifier	ID	3-3	R	N/A	573	999	IK403 = 1: "Required Data Element Missing"	2430.DTP01 must be present.
X223 486 2430 DTP01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2430.DTP01 must be "573".
X223 486 2430 DTP02 010	Date /Time Format Qualifier	ID	2-3	R	N/A	D8	999	IK403 = 1: "Required Data Element Missing"	2430.DTP02 must be present.
X223 486 2430 DTP02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2430.DTP02 must be "D8".
X223 486 2430 DTP03 010	Adjudication or Payment Date	AN	1-35	R	N/A	CCYYMMDD	999	IK403 = 1: "Required Data Element Missing"	2430.DTP03 must be present.
X223 486 2430 DTP03 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 8: "Invalid Date"	2430.DTP03 must be a valid date in CCYYMMDD format.
X223 486 2430 DTP03 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 510: "Future date" CSC 516 "Adjudication or Payment Date"	2430.DTP03 must not be a future date.
X223 487 2430 AMT 020	REMAINING PATIENT LIABILITY	N/A	1	S	N/A	N/A	999	IK304 = 5: "Segment Exceeds Maximum Use"	Only one iteration of 2430.AMT is allowed
X223 487 2430 AMT 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A8: "Acknowledgement / Rejected for relational field..." CSC 6: Balance due from the subscriber EIC: GB "Other Insured"	If 2320 AMT (EAF) is present for the same payer, the 2430 AMT (EAF) must not be present.
X223 487 2430 AMT01 010	Amount Qualifier Code	ID	1-3	R	N/A	EAF	999	IK403 = 1: "Required Data Element Missing"	2430.AMT01 must be present.
X223 487 2430 AMT01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 7: "Invalid Code Value"	2430.AMT01 must be "EAF".
X223 487 2430 AMT02 005	Non-Covered Amount	R	1-18	R	N/A	N/A	999	IK403 = 1: "Required Data Element Missing"	2430.AMT02 must be present.
X223 487 2430 AMT02 010	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 6: "Invalid Character in Data Element"	2430 .AMT02 must be numeric.
X223 487 2430 AMT02 015	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 693: "Amount must be greater than or equal to zero" CSC 596: "Non-covered Charge Amount"	2430.AMT02 must be >= 0.
X223 487 2430 AMT02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK403 = 5: "Data Element Too Long"	2430.AMT02 must be <= 99,999,999.99.
X223 487 2430 AMT02 025	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 596: "Non-covered Charge Amount"	N/A
X223 487 2430 AMT02 030	N/A	N/A	N/A	N/A	N/A	N/A	277	CSCC A7: "Acknowledgement /Rejected for Invalid Information..." CSC 512: "Length invalid for receiver's application system" CSC 596: "Non-covered Charge Amount"	2430.AMT02 is limited to 0, 1 or 2 decimal positions.
X223 487 2430 AMT03 010	Credit/Debit Flag Code	ID	1-1	N/U	N/A	N/A	999	IK403 = I10: "Implementation "Not Used" Element Present"	Must not be present.
X223 488 SE 010	TRANSACTION SET TRAILER	N/A	1	R	N/A	N/A	999	IK502 = 2: "Transaction Set Trailer Missing".	SE must be present.
X223 488 SE01 010	Transaction Segment Count	N0	1-10	R	N/A	N/A	999	IK502 = 4: "Number of Included Segments Does Not Match Actual Count".	SE01 must be present.
X223 488 SE01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 4: "Number of Included Segments Does Not Match Actual Count".	SE01 must be numeric.
X223 488 SE01 030	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 4: "Number of Included Segments Does Not Match Actual Count".	SE01 must = the transaction segment count.
X223 488 SE01 040	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 4: "Number of Included Segments Does Not Match Actual Count".	SE01 must be > 0.
X223 488 SE02 010	Transaction Set Control Number	AN	4-9	R	N/A	N/A	999	IK502 = 3: "Transaction Set Control Number in Header and Trailer Do Not Match".	SE02 must be present.
X223 488 SE02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	IK502 = 3: "Transaction Set Control Number in Header and Trailer Do Not Match".	SE02 must = ST02.
X223 C9 GE 010	Functional Group Trailer	N/A	1	R	N/A	N/A	999	AK905: 3 "Functional Group Trailer Missing"	GE must be present.
X223 C9 GE01 010	Number of Transaction Sets Included	N0	1-6	R	N/A	N/A	999	AK905: 5 "Number of Included Transaction Sets Does Not Match Actual Count".	GE01 must be present.
X223 C9 GE01 020	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 5 "Number of Included Transaction Sets Does Not Match Actual Count".	GE01 must be numeric.
X223 C9 GE01 030	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 5 "Number of Included Transaction Sets Does Not Match Actual Count".	GE01 must = the number of transaction sets included in the functional group.
X223 C9 GE01 040	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 5 "Number of Included Transaction Sets Does Not Match Actual Count".	GE01 must be > 0.
X223 C9 GE02 010	Group Control Number	N0	1-9	R	N/A	N/A	999	AK905: 4 "Group Control Number in the Functional Group Header and Trailer Do Not Agree".	GE02 must be present.
X223 C9 GE02 020	N/A	N/A	N/A	N/A	N/A	N/A	999	AK905: 4 "Group Control Number in the Functional Group Header and Trailer Do Not Agree".	GE02 must = GS06.
X223 C10 IEA 007	Interchange Control Trailer	N/A	1	R	N/A	N/A	TA1	TA105 = 022: "Invalid Control Structure" -OR- TA105 = 023: "Improper (Premature) End-of-File (Transmission)" -OR- TA105: 024 "Invalid Interchange Content".	IEA must be present.
X223 C10 IEA 017	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 022: "Invalid Control Structure" -OR- TA105 = 023: "Improper (Premature) End-of-File (Transmission)" -OR - TA105: 024 "Invalid Interchange Content".	Only one iteration of IEA is allowed.
X223 C10 IEA01 010	Number of Included Functional Groups	N0	1-5	R	N/A	N/A	TA1	TA105 = 021: "Invalid Number of Included Groups Value".	IEA01 must be present.
X223 C10 IEA01 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 021: "Invalid Number of Included Groups Value".	IEA01 must be numeric.
X223 C10 IEA01 030	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 021: "Invalid Number of Included Groups Value".	IEA01 must = the number of functional groups included in the interchange.
X223 C10 IEA01 040	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 021: "Invalid Number of Included Groups Value".	IEA01 must be > 0.
X223 C10 IEA02 010	Interchange Control Number	N0	9-9	R	N/A	N/A	TA1	TA105 = 001: "The Interchange Control Number in the Header and Trailer Do Not Match".	IEA02 must be present.
X223 C10 IEA02 020	N/A	N/A	N/A	N/A	N/A	N/A	TA1	TA105 = 001: "The Interchange Control Number in the Header and Trailer Do Not Match".	IEA02 must = ISA13

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