United Nations Directories 
for Electronic Data Interchange for

     Administration, Commerce and Transport


 

 UN/EDIFACT

 



      Change indicators

        a plus sign (+)    for an addition
        an asterisk (*)    for an amendment to structure
        a hash sign (#)    for changes to names
        a vertical bar (|) for changes to text for descriptions,
                           notes and functions
        a minus sign (-)   for a deletion
        an X sign (X)      for marked for deletion


       ADI  HEALTH CARE CLAIM ADJUDICATION INFORMATION

       Function: To provide adjudication information for all
                 services in a health care claim.

010    E206 OBJECT IDENTIFICATION                      M    3
       7402  Object identifier                         M      an..35
       7405  Object identification code qualifier      C      an..3
       4405  Status description code                   C      an..3

020    E021 SERVICE                                    C    3
       7135  Product identifier                        M      an..35
       1131  Code list identification code             C      an..17
       9629  Procedure modification code               C      an..3
       9629  Procedure modification code               C      an..3
       9629  Procedure modification code               C      an..3
       9629  Procedure modification code               C      an..3

030    1229 ACTION CODE                                C    1 an..3

040    E017 MONETARY AMOUNT                            C   15
       5025  Monetary amount type code qualifier       C      an..3
       5004  Monetary amount                           C      n..35
       6345  Currency identification code              C      an..3
       6343  Currency type code qualifier              C      an..3
       4405  Status description code                   C      an..3

050    6060 QUANTITY                                   C    3 an..35

060    E030 ADJUSTMENT INFORMATION                     C   15
       9619  Adjustment category code                  M      an..3
       4465  Adjustment reason description code        M      an..3
       5004  Monetary amount                           C      n..35

070    9620 POLICY LIMITATION IDENTIFIER               C    4 an..10

080    5389 PRODUCT GROUP NAME CODE                    C    1 an..25

090    E507 DATE/TIME/PERIOD                           C    1
       2005  Date or time or period function code
             qualifier                                 M      an..3
       2380  Date or time or period text               C      an..35
       2379  Date or time or period format code        C      an..3

100    9639 DIAGNOSIS CATEGORY CODE                    C    1 an..3

110    5482 PERCENTAGE                                 C    1 n..10



Segment ADI is used in the following Messages: 

       IHCLME


    
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UN/EDIFACT Directories