The Product/Service Line Item segment is used to identify individual product/service items that typically are aggregated into an Invoice. Each instance of a Product/Service Line Item corresponds to a unique product delivered or service rendered.
Seq# | DataElement | Description | Must Implement | Flags | Cardinality | Length | C.LEN | Vocabulary | DataType |
---|---|---|---|---|---|---|---|---|---|
PSL | |||||||||
1 | 01955 | Provider Product/Service Line Item Number | SHALL | [1..1] | EI | ||||
2 | 01956 | Payer Product/Service Line Item Number | [0..1] | EI | |||||
3 | 01957 | Product/Service Line Item Sequence Number | SHALL | [1..1] | [1..4] | SI | |||
4 | 01958 | Provider Tracking ID | [0..1] | EI | |||||
5 | 01959 | Payer Tracking ID | [0..1] | EI | |||||
6 | 01960 | Product/Service Line Item Status | SHALL | [1..1] | CWE | ||||
7 | 01961 | Product/Service Code | SHALL | [1..1] | CWE | ||||
8 | 01962 | Product/Service Code Modifier | [0..0] | CWE | |||||
9 | 01963 | Product/Service Code Description | # | [0..1] | 80 | ST | |||
10
|
01964 | Product/Service Effective Date |
MAY
True: False: |
C |
[1..1] [0..1] |
DTM | |||
11 | 01965 | Product/Service Expiration Date | [0..1] | DTM | |||||
12
|
01966 | Product/Service Quantity |
MAY
True: False: |
C |
[1..1] [0..1] |
CQ | |||
13
|
01967 | Product/Service Unit Cost |
MAY
True: False: |
C |
[1..1] [0..1] |
CP | |||
14
|
01968 | Number of Items per Unit |
MAY
True: False: |
C# |
[1..1] [0..1] |
10 | NM | ||
15
|
01969 | Product/Service Gross Amount |
MAY
True: False: |
C |
[1..1] [0..1] |
CP | |||
16
|
01970 | Product/Service Billed Amount |
MAY
True: False: |
C |
[1..1] [0..1] |
CP | |||
17 | 01971 | Product/Service Clarification Code Type | [0..0] | CWE | |||||
18 | 01972 | Product/Service Clarification Code Value | = | [0..0] | 40 | ST | |||
19 | 01973 | Health Document Reference Identifier | [0..0] | EI | |||||
20 | 01974 | Processing Consideration Code | [0..0] | CWE | |||||
21 | 01975 | Restricted Disclosure Indicator | SHALL | [1..1] | [1..4] | ID | |||
22 | 01976 | Related Product/Service Code Indicator | [0..1] | CWE | |||||
23 | 01977 | Product/Service Amount for Physician | [0..1] | CP | |||||
24 | 01978 | Product/Service Cost Factor | # | [0..1] | 5 | NM | |||
25 | 01933 | Cost Center | [0..1] | CX | |||||
26 | 01980 | Billing Period | [0..1] | DR | |||||
27 | 01981 | Days without Billing | = | [0..1] | 5 | NM | |||
28 | 01982 | Session-No | [0..1] | [1..4] | NM | ||||
29 | 01983 | Executing Physician ID | [0..1] | XCN | |||||
30 | 01984 | Responsible Physician ID | [0..1] | XCN | |||||
31 | 01985 | Role Executing Physician | [0..1] | CWE | |||||
32 | 01986 | Medical Role Executing Physician | [0..1] | CWE | |||||
33 | 01987 | Side of body | [0..1] | CWE | |||||
34 | 01988 | Number of TP's PP | # | [0..1] | 6 | NM | |||
35 | 01989 | TP-Value PP | [0..1] | CP | |||||
36 | 01990 | Internal Scaling Factor PP | # | [0..1] | 4 | NM | |||
37 | 01991 | External Scaling Factor PP | # | [0..1] | 4 | NM | |||
38 | 01992 | Amount PP | [0..1] | CP | |||||
39 | 01993 | Number of TP's Technical Part | # | [0..1] | 6 | NM | |||
40 | 01994 | TP-Value Technical Part | [0..1] | CP | |||||
41 | 01995 | Internal Scaling Factor Technical Part | # | [0..1] | 4 | NM | |||
42 | 01996 | External Scaling Factor Technical Part | # | [0..1] | 4 | NM | |||
43 | 01997 | Amount Technical Part | [0..1] | CP | |||||
44 | 01998 | Total Amount Professional Part + Technical Part | [0..1] | CP | |||||
45 | 01999 | VAT-Rate | = | [0..1] | 3 | NM | |||
46 | 02000 | Main-Service | [0..1] | [1..20] | ID | ||||
47 | 02001 | Validation | [0..1] | [1..1] | ID | ||||
48 | 02002 | Comment | = | [0..1] | 255 | ST |
Definition: Unique Product/Service Line Item Number assigned by the Provider Application.
Definition: Unique Product/Service Line Item Number assigned by the Payer Application.
Definition: Unique sequence number for the Product/Service Line Item – starts with 1, then 2, etc. for each unique Product/Service Line Item in this Invoice.
Definition: Identifier for this Product/Service Line Item assigned by the Provider Application. This will be echoed on all interactions between participants for this Product/Service Line Item.
Definition: Identifier for this Product/Service Line Item assigned by the Payer Application. This will be echoed on all interactions between participants for this Product/Service Line Item.
Definition: Processing status for the Product/Service Code. Refer to User-defined Table 0559 – Product/Service Status in Chapter 2C, Code Tables, for suggested values.
Definition: Code describing the service that was delivered/received. Refer to User-defined Table 0879 – Product/Service Code in Chapter 2C, Code Tables, for suggested values.
Definition: Additional optional modifier(s) for the Product/Service Code (e.g., after hours – evening, after hours – weekend); repeats up to 5 times. Refer to User-defined Table 0880 – Product/Service Code Modifier in Chapter 2C, Code Tables, for suggested values.
Definition: Text describing Product/Service Code in PSL.
Definition: [ Start ] Date/Time product/service was delivered/received.
Definition: [ End ] Date/Time product/service was delivered/received. If specified, must be greater than or equal to Product/Service Effective Date.
Definition: Amount that has been negotiated for this Product/Service Code on PSL between a Provider and Payer for each unit. Refer to User-defined Table 0560 – Quantity Units in Chapter 2C, Code Tables, for valid values.
Definition: This field contains the cost per unit either in monetary amount or in points.
Examples:
1. Qty * cost/unit = gross amount
2. Qty * cost/unit * factor = gross amount
3. Qty * cost/point * factor * points = gross amount
Definition: Number of items in each unit – for Services, this should be set to 1.
Definition: = Product/Service Quantity * Product/Service Unit Cost
Definition: Amount that is being billed for this Product/Service Code on PSL, = Product/Service Gross Amount + sum of all Product/Service Adjustments on ADJ for this Product/Service Line Item.
= Product/Service Gross Amount + sum of all Product/Service Adjustments on ADJ
Definition: Additional codes describing the Product/Service Code on PSL – examples are Northern Allowance, Data Center Numbers, Sequence Numbers; repeats with Product/Service Clarification Code Value. Refer to User-defined Table 0561 – Product/Services Clarification Codes in Chapter 2C, Code Tables, for suggested values.
Definition: Actual value for Product/Service Clarification Code Type (40) – examples are "Y", "N" for Northern Allowance, an actual number for a Data Center Number; repeats with Product/Service Clarification Code Type.
Repeats with Product/Service Clarification Code Type.
Definition: Health Documents (electronic or paper) that support this Product/Service Line Item. This includes such health documents as forms used to register a claim with a Payer, reports, medical images, etc.
Definition: Codes indicating special processing requested of Payer for this Product/Service Line Item (e.g., hold until paper supporting documentation is received by Payer). Refer to User-defined Table 0562 – Processing Consideration Codes in Chapter 2C, Code Tables, for suggested values.
Definition: Set to "Yes" if information on this invoice should be treated with increased confidentiality/security. Refer to User-defined Table 0532 – Expanded Yes/No Indicator in Chapter 2C, Code Tables, for suggested values.
Definition: Two Product /Service Line Items (PSL-7) may be in a relation to each other. One could be an addition to another. In this case this field contains the Code of PSL-7 of the "master" Product/Service Line Item. Refer to User-defined Table 0879 – Product/Service Code in Chapter 2C, Code Tables, for suggested values.
Definition: Monetary Amount of product/service item which is for the physician.
Definition: Factor to increase the billed amount.
(Definition from IVC.20 in Ch. 16)
Definition: Cost centers are organizational units or activities that provide goods and services. In this context, it would be the department which delivered the Service/Product Line Item, e.g., Radiology, Emergency Room.
(Definition from PSL.25 in Ch. 16)
Definition: Cost centers are organizational units or activities that provide goods and services. In this context, it would be the department which delivered the Service/Product Line Item, e.g., Radiology, Emergency Room.
Definition: Begin and end of billing period.
Definition: Number of Days for which no invoice is created.
Definition: Several line items may be grouped to a session.
Definition: ID of the physician who is providing the Service, e.g., executing the radiology-exam (EAN ID = European Article Numbering).
Definition: ID of the physician who is responsible for the Service.
Definition: Account role of the physician, for example only billing for the professional part, the technical part or both. Refer to User-defined Table 0881 – Role Executing Physician in Chapter 2C, Code Tables, for suggested values.
Definition: The role of the Physician ("self-employed" or "employed"). Refer to User-defined Table 0882 – Medical Role Executing Physician in Chapter 2C, Code Tables, for suggested values.
Definition: Left / right. Refer to User-defined Table 0894 – Side of Body in Chapter 2C, Code Tables, for suggested values.
Definition: Cost of the service "professional part" expressed in "points".
Definition: Monetary Value of one "point" for the professional part of the service.
Definition: Internal Scaling Factor for the amount of the professional part of the service.
Definition: External Scaling Factor for the amount of the professional part of the service.
Definition: Total Amount for the professional part of this service.
Definition: Cost of the service (Technical Part) expressed in "points".
Definition: Monetary Value of one "point" for the technical part of the service.
Definition: Internal Scaling Factor for the amount of the technical part of the service.
Definition: External Scaling Factor for the amount of the technical part of the service.
Definition: Total Amount for the technical part of this service.
Definition: Total Amount of the cost of this service (Professional plus technical part)
Definition: VAT–Rate Applied on the total amount of this service.
Definition: Main service.
Definition: Service line item has passed an approved validator software (yes/no). For reason see PSL-48. Refer to HL7 Table 0136 – Yes/No Indicator in Chapter 2C, Code Tables, for suggested values.
Definition: Reason why the service line item has not passed the validator software.