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Hierarchical Levels are placeholders to indicate where we are in a transaction set. They allow the reader of a claim file to find his place after missing segments. They should be absolute placeholders. They are as follows:
| |
 |
|
|
HL |
20 |
Billing Provider |
2000A |
HL |
22 |
Subscriber |
2000B |
HL |
23 |
Dependent |
2000C |
NM1 |
40 |
Receiver |
1000B |
NM1 |
41 |
Submitter |
1000A |
NM1 |
77 |
Service Location |
2310D |
NM1 |
77 |
Service Location Other Payer |
2330G |
NM1 |
77 |
Service Location |
2420C |
NM1 |
82 |
Rendering Provider |
2310B |
NM1 |
82 |
Rendering Provider Other Payer |
2330E |
NM1 |
82 |
Rendering Provider |
2420A |
NM1 |
85 |
Billing Provider |
2000AA |
NM1 |
87 |
Pay to Provider |
2000AB |
NM1 |
DK |
Ordering Provider |
2420E |
NM1 |
DN |
Referring |
2310A |
NM1 |
DN |
Referring Provider Other Payer |
2330D |
NM1 |
DN |
Referring |
2420F |
NM1 |
DQ |
Supervising Prov |
2310E |
NM1 |
DQ |
Supervising Prov Other Payer |
2330H |
NM1 |
DQ |
Supervising Prov |
2420D |
NM1 |
FA |
Service Facility |
2310D |
NM1 |
FA |
Service Facility Other Payer |
2330G |
NM1 |
FA |
Service Facility |
2420C |
NM1 |
IL |
Subscriber |
2000BA |
NM1 |
IL |
Other Subscriber |
2330A |
NM1 |
LI |
Independent Lab |
2310D |
NM1 |
LI |
Independent Lab Other Payer |
2330G |
NM1 |
LI |
Independent Lab |
2420C |
NM1 |
PR |
Other Payer |
2330B |
NM1 |
PR |
Other Payer |
2420G |
NM1 |
P3 |
Primary Care Provider |
2310A |
NM1 |
P3 |
Primary Care Provider Other Payer |
2330D |
NM1 |
P3 |
Primary Care Provider |
2420F |
NM1 |
QB |
Purchased Service Provider |
2310C |
NM1 |
QB |
Purchased Service Provider Other Payer |
2330E |
NM1 |
QB |
Purchased Service Provider |
2420B |
NM1 |
QC |
Patient |
2000C |
NM1 |
QC |
Patient Other Payer |
2330C |
NM1 |
TL |
Test Lab |
2310D |
NM1 |
TL |
Test Lab Other Payer |
2330G |
NM1 |
TL |
Test Lab |
2420C |
The 2000 A, B; and C loops identify the Primary Billing Provider and the Primary Payer identification numbers for the Subscriber and Patient.
The 2300 and 2310 loops identify claim level entities and individuals whose numbers are usually assigned by the primary payer.
The 2330 loops identify entities and individuals as they are known to the secondary and tertiary payers.
The 2400 loops identify entities and individuals who are applicable to a specific detail line instead of the entire claim. Sometimes they are assigned numbers by the secondary and tertiary payers also.
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