gm_x12 1.6.0
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- checksums.yaml +7 -0
- data/.gitignore +18 -0
- data/.project +13 -0
- data/.ruby-version +1 -0
- data/Gemfile +4 -0
- data/LICENSE +22 -0
- data/README.md +100 -0
- data/Rakefile +26 -0
- data/example/factory.rb +92 -0
- data/example/parse.rb +57 -0
- data/init.rb +1 -0
- data/lib/x12.rb +48 -0
- data/lib/x12/base.rb +226 -0
- data/lib/x12/composite.rb +37 -0
- data/lib/x12/empty.rb +43 -0
- data/lib/x12/field.rb +94 -0
- data/lib/x12/loop.rb +96 -0
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- data/lib/x12/segment.rb +114 -0
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- data/lib/x12/version.rb +3 -0
- data/lib/x12/xmldefinitions.rb +173 -0
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- data/misc/T814.xml +29 -0
- data/misc/T815.xml +40 -0
- data/misc/T816.xml +37 -0
- data/misc/T820.xml +58 -0
- data/misc/T821.xml +180 -0
- data/misc/T829.xml +48 -0
- data/misc/T83.xml +55 -0
- data/misc/T831.xml +41 -0
- data/misc/T835.xml +28 -0
- data/misc/T836.xml +63 -0
- data/misc/T837.xml +38 -0
- data/misc/T844.xml +30 -0
- data/misc/T845.xml +34 -0
- data/misc/T846.xml +66 -0
- data/misc/T847.xml +35 -0
- data/misc/T848.xml +30 -0
- data/misc/T849.xml +30 -0
- data/misc/T850.xml +39 -0
- data/misc/T852.xml +31 -0
- data/misc/T853.xml +48 -0
- data/misc/T854.xml +47 -0
- data/misc/T855.xml +29 -0
- data/misc/T856.xml +31 -0
- data/misc/T859.xml +69 -0
- data/misc/T868.xml +29 -0
- data/misc/T875.xml +150 -0
- data/misc/T88.xml +48 -0
- data/misc/T883.xml +36 -0
- data/misc/T886.xml +36 -0
- data/misc/T887.xml +42 -0
- data/misc/T888.xml +34 -0
- data/misc/T889.xml +37 -0
- data/misc/T890.xml +43 -0
- data/misc/T891.xml +47 -0
- data/misc/T892.xml +52 -0
- data/misc/T893.xml +29 -0
- data/misc/T894.xml +39 -0
- data/misc/T897.xml +31 -0
- data/misc/T9.xml +50 -0
- data/misc/T90.xml +31 -0
- data/misc/T901.xml +234 -0
- data/misc/T902.xml +31 -0
- data/misc/T903.xml +30 -0
- data/misc/T904.xml +33 -0
- data/misc/T906.xml +31 -0
- data/misc/T91.xml +107 -0
- data/misc/T912.xml +32 -0
- data/misc/T913.xml +43 -0
- data/misc/T92.xml +98 -0
- data/misc/T921.xml +33 -0
- data/misc/T922.xml +33 -0
- data/misc/T923.xml +35 -0
- data/misc/T924.xml +29 -0
- data/misc/T927.xml +29 -0
- data/misc/T934.xml +34 -0
- data/misc/T935.xml +157 -0
- data/misc/T936.xml +86 -0
- data/misc/T937.xml +47 -0
- data/misc/T938.xml +35 -0
- data/misc/T939.xml +29 -0
- data/misc/T940.xml +32 -0
- data/misc/T943.xml +53 -0
- data/misc/T944.xml +43 -0
- data/misc/T945.xml +56 -0
- data/misc/T950.xml +75 -0
- data/misc/T951.xml +36 -0
- data/misc/T952.xml +30 -0
- data/misc/T955.xml +32 -0
- data/misc/T959.xml +29 -0
- data/misc/T960.xml +40 -0
- data/misc/T962.xml +38 -0
- data/misc/T963.xml +129 -0
- data/misc/T964.xml +46 -0
- data/misc/T969.xml +38 -0
- data/misc/T974.xml +28 -0
- data/misc/T976.xml +32 -0
- data/misc/T98.xml +1511 -0
- data/misc/T980.xml +35 -0
- data/misc/T981.xml +46 -0
- data/misc/T982.xml +32 -0
- data/misc/T983.xml +29 -0
- data/misc/T984.xml +30 -0
- data/misc/T985.xml +28 -0
- data/misc/T986.xml +28 -0
- data/misc/T987.xml +36 -0
- data/misc/T988.xml +48 -0
- data/misc/T990.xml +34 -0
- data/misc/T998.xml +30 -0
- data/misc/T999.xml +39 -0
- data/misc/TA.xml +34 -0
- data/misc/TA1.xml +32 -0
- data/misc/TAX.xml +40 -0
- data/misc/TBI.xml +35 -0
- data/misc/TC2.xml +29 -0
- data/misc/TCD.xml +43 -0
- data/misc/TD1.xml +37 -0
- data/misc/TD3.xml +37 -0
- data/misc/TD4.xml +32 -0
- data/misc/TD5.xml +42 -0
- data/misc/TDS.xml +31 -0
- data/misc/TDT.xml +31 -0
- data/misc/TED.xml +35 -0
- data/misc/TEM.xml +32 -0
- data/misc/TER.xml +33 -0
- data/misc/TF.xml +31 -0
- data/misc/TFR.xml +31 -0
- data/misc/TFS.xml +35 -0
- data/misc/THE.xml +32 -0
- data/misc/TI.xml +34 -0
- data/misc/TI01.xml +34 -0
- data/misc/TI03.xml +29 -0
- data/misc/TI05.xml +65 -0
- data/misc/TI10.xml +28 -0
- data/misc/TI11.xml +41 -0
- data/misc/TI13.xml +29 -0
- data/misc/TI14.xml +30 -0
- data/misc/TI40.xml +36 -0
- data/misc/TI43.xml +61 -0
- data/misc/TI58.xml +32 -0
- data/misc/TI60.xml +29 -0
- data/misc/TI61.xml +30 -0
- data/misc/TI62.xml +30 -0
- data/misc/TI63.xml +33 -0
- data/misc/TIA.xml +34 -0
- data/misc/TID.xml +36 -0
- data/misc/TII.xml +32 -0
- data/misc/TIS.xml +31 -0
- data/misc/TLN.xml +49 -0
- data/misc/TMD.xml +36 -0
- data/misc/TOA.xml +32 -0
- data/misc/TOO.xml +30 -0
- data/misc/TOV.xml +33 -0
- data/misc/TPB.xml +31 -0
- data/misc/TPD.xml +31 -0
- data/misc/TRF.xml +32 -0
- data/misc/TRL.xml +32 -0
- data/misc/TRN.xml +31 -0
- data/misc/TRS.xml +32 -0
- data/misc/TS.xml +34 -0
- data/misc/TS2.xml +46 -0
- data/misc/TS3.xml +51 -0
- data/misc/TSD.xml +29 -0
- data/misc/TSI.xml +31 -0
- data/misc/TSP.xml +31 -0
- data/misc/TST.xml +44 -0
- data/misc/TSU.xml +35 -0
- data/misc/TT.xml +29 -0
- data/misc/TUD.xml +30 -0
- data/misc/TXI.xml +37 -0
- data/misc/TXN.xml +37 -0
- data/misc/TXP.xml +37 -0
- data/misc/UC.xml +31 -0
- data/misc/UCS.xml +35 -0
- data/misc/UD.xml +44 -0
- data/misc/UDA.xml +34 -0
- data/misc/UIT.xml +30 -0
- data/misc/UM.xml +37 -0
- data/misc/UQS.xml +31 -0
- data/misc/UR.xml +29 -0
- data/misc/USD.xml +39 -0
- data/misc/USI.xml +30 -0
- data/misc/UWI.xml +31 -0
- data/misc/V1.xml +36 -0
- data/misc/V2.xml +44 -0
- data/misc/V3.xml +31 -0
- data/misc/V4.xml +28 -0
- data/misc/V5.xml +30 -0
- data/misc/V9.xml +47 -0
- data/misc/VAD.xml +38 -0
- data/misc/VAR.xml +34 -0
- data/misc/VAT.xml +39 -0
- data/misc/VC.xml +40 -0
- data/misc/VC1.xml +42 -0
- data/misc/VDI.xml +42 -0
- data/misc/VEH.xml +43 -0
- data/misc/VID.xml +40 -0
- data/misc/VR.xml +36 -0
- data/misc/VRC.xml +32 -0
- data/misc/W01.xml +43 -0
- data/misc/W03.xml +34 -0
- data/misc/W04.xml +42 -0
- data/misc/W05.xml +35 -0
- data/misc/W06.xml +39 -0
- data/misc/W07.xml +38 -0
- data/misc/W08.xml +36 -0
- data/misc/W09.xml +36 -0
- data/misc/W1.xml +28 -0
- data/misc/W10.xml +36 -0
- data/misc/W12.xml +49 -0
- data/misc/W13.xml +32 -0
- data/misc/W14.xml +32 -0
- data/misc/W15.xml +33 -0
- data/misc/W17.xml +36 -0
- data/misc/W18.xml +30 -0
- data/misc/W19.xml +45 -0
- data/misc/W2.xml +43 -0
- data/misc/W20.xml +37 -0
- data/misc/W27.xml +37 -0
- data/misc/W28.xml +35 -0
- data/misc/W3.xml +33 -0
- data/misc/W4.xml +32 -0
- data/misc/W5.xml +33 -0
- data/misc/W6.xml +31 -0
- data/misc/W66.xml +37 -0
- data/misc/W76.xml +33 -0
- data/misc/WLD.xml +37 -0
- data/misc/WS.xml +30 -0
- data/misc/X01.xml +37 -0
- data/misc/X02.xml +32 -0
- data/misc/X1.xml +44 -0
- data/misc/X2.xml +33 -0
- data/misc/X4.xml +46 -0
- data/misc/X7.xml +29 -0
- data/misc/XD.xml +32 -0
- data/misc/XH.xml +34 -0
- data/misc/XPO.xml +31 -0
- data/misc/XQ.xml +32 -0
- data/misc/Y1.xml +36 -0
- data/misc/Y2.xml +37 -0
- data/misc/Y3.xml +38 -0
- data/misc/Y4.xml +37 -0
- data/misc/Y5.xml +28 -0
- data/misc/Y6.xml +30 -0
- data/misc/Y7.xml +32 -0
- data/misc/YNQ.xml +37 -0
- data/misc/ZA.xml +35 -0
- data/misc/ZC1.xml +36 -0
- data/misc/ZD.xml +36 -0
- data/misc/ZR.xml +43 -0
- data/misc/ZT.xml +33 -0
- data/misc/rdoc_template.rb +697 -0
- data/test/tc_factory_270.rb +170 -0
- data/test/tc_factory_270interchange.rb +306 -0
- data/test/tc_factory_271.rb +235 -0
- data/test/tc_factory_276.rb +42 -0
- data/test/tc_factory_277.rb +43 -0
- data/test/tc_factory_834.rb +265 -0
- data/test/tc_factory_837p.rb +285 -0
- data/test/tc_factory_997.rb +138 -0
- data/test/tc_factory_999.rb +128 -0
- data/test/tc_parse_270.rb +98 -0
- data/test/tc_parse_270interchange.rb +184 -0
- data/test/tc_parse_271.rb +158 -0
- data/test/tc_parse_276.rb +151 -0
- data/test/tc_parse_277.rb +128 -0
- data/test/tc_parse_834.rb +49 -0
- data/test/tc_parse_835.rb +215 -0
- data/test/tc_parse_837p.rb +82 -0
- data/test/tc_parse_997.rb +147 -0
- data/test/tc_parse_999.rb +89 -0
- data/x12.gemspec +21 -0
- metadata +1946 -0
data/misc/835.xml
ADDED
@@ -0,0 +1,84 @@
|
|
1
|
+
<!--
|
2
|
+
This file is part of the X12Parser library that provides tools to
|
3
|
+
manipulate X12 messages using Ruby native syntax.
|
4
|
+
|
5
|
+
Copyright (C) 2012 P&D Technical Solutions, LLC
|
6
|
+
|
7
|
+
This library is free software; you can redistribute it and/or
|
8
|
+
modify it under the terms of the GNU Lesser General Public
|
9
|
+
License as published by the Free Software Foundation; either
|
10
|
+
version 2.1 of the License, or (at your option) any later version.
|
11
|
+
|
12
|
+
This library is distributed in the hope that it will be useful,
|
13
|
+
but WITHOUT ANY WARRANTY; without even the implied warranty of
|
14
|
+
MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the GNU
|
15
|
+
Lesser General Public License for more details.
|
16
|
+
|
17
|
+
You should have received a copy of the GNU Lesser General Public
|
18
|
+
License along with this library; if not, write to the Free Software
|
19
|
+
Foundation, Inc., 51 Franklin Street, Fifth Floor, Boston, MA 02110-1301 USA
|
20
|
+
|
21
|
+
$Id: 835OA.xml 2013-06-08 mjp using version 5010 $
|
22
|
+
Non-standard implementation of the 835 transaction
|
23
|
+
Allows for multiple ST/SE segments
|
24
|
+
-->
|
25
|
+
|
26
|
+
<Definition>
|
27
|
+
<Loop name="835" required="y">
|
28
|
+
<Segment name="ISA" max="1" required="y" />
|
29
|
+
<Segment name="TA1" max="1" required="n" />
|
30
|
+
<Segment name="GS" max="1" required="y" />
|
31
|
+
<Loop name="L835" max="inf" comment="This X12 Transaction Set contains the format and establishes the data contents of the Professional Healthcare Claim Transaction Set (837p) for use within the context of an Electronic Data Interchange (EDI) environment.">
|
32
|
+
<Segment name="ST" max="1" required="y" />
|
33
|
+
<Segment name="BPR" max="1" required="y" comment="Fianancial Information" />
|
34
|
+
<Segment name='NTE' max='inf' required='n' comment="Note / Special Instruction" />
|
35
|
+
<Segment name="TRN" max="1" required="y" comment="Re-association Trace Number" />
|
36
|
+
<Segment name="CUR" max="1" required="n" />
|
37
|
+
<Segment name="REF" max="2" required="n" />
|
38
|
+
<Segment name="DTM" max="1" required="n" comment="Production Date" />
|
39
|
+
<Loop name="L1000A" max="1" required="y" comment="Payer Identification">
|
40
|
+
<Segment name="N1" max="1" required="y" />
|
41
|
+
<Segment name="N3" max="1" required="y" />
|
42
|
+
<Segment name="N4" max="1" required="y" />
|
43
|
+
<Segment name="REF" max="4" required="n" />
|
44
|
+
<Segment name="PER" max="inf" required="n" comment="4010 allows for 1 segment, 5010 allows for more than 1 segment"/>
|
45
|
+
</Loop>
|
46
|
+
<Loop name="L1000B" max="1" required="y" comment="Payee Identification" >
|
47
|
+
<Segment name="N1" max="1" required="y" />
|
48
|
+
<Segment name="N3" max="1" required="n" />
|
49
|
+
<Segment name="N4" max="1" required="n" />
|
50
|
+
<Segment name="REF" max="inf" required="n" />
|
51
|
+
</Loop>
|
52
|
+
<Loop name="L2000" required="n" comment="Claim Payment Information" >
|
53
|
+
<Segment name="LX" max="1" required="n" />
|
54
|
+
<Segment name="TS3" max="1" required="n" />
|
55
|
+
<Segment name="TS2" max="1" required="n" />
|
56
|
+
<Loop name="L2100" min="1" comment="The Loop 2100 CLP Claim Payment Information Segment begins data on each individual claim for a service provider within the 835 Transaction." >
|
57
|
+
<Segment name="CLP" max="1" required="y" />
|
58
|
+
<Segment name="CAS" max="99" required="n" />
|
59
|
+
<Segment name="NM1" min="1" max="7" required="y" />
|
60
|
+
<Segment name="MIA" max="1" required="n" />
|
61
|
+
<Segment name="MOA" max="1" required="n" />
|
62
|
+
<Segment name="REF" max="15" required="n" />
|
63
|
+
<Segment name="DTM" max="4" required="n" />
|
64
|
+
<Segment name="PER" max="3" required="n" />
|
65
|
+
<Segment name="AMT" max="14" required="n" />
|
66
|
+
<Segment name="QTY" max="15" required="n" />
|
67
|
+
<Loop name="L2110" max="999" required="n" comment="Service Payment Information">
|
68
|
+
<Segment name="SVC" max="1" required="n" />
|
69
|
+
<Segment name="DTM" max="3" required="n" />
|
70
|
+
<Segment name="CAS" max="99" required="n" />
|
71
|
+
<Segment name="REF" max="24" required="n" />
|
72
|
+
<Segment name="AMT" max="12" required="n" />
|
73
|
+
<Segment name="QTY" max="6" required="n" />
|
74
|
+
<Segment name="LQ" max="99" required="n" />
|
75
|
+
</Loop>
|
76
|
+
</Loop>
|
77
|
+
</Loop>
|
78
|
+
<Segment name="PLB" max="inf" required="n" comment="Provider Level Adjustment" />
|
79
|
+
<Segment name="SE" required="y" />
|
80
|
+
</Loop>
|
81
|
+
<Segment name="GE" max="1" required="y"/>
|
82
|
+
<Segment name="IEA" max="1" required="y"/>
|
83
|
+
</Loop>
|
84
|
+
</Definition>
|
data/misc/837p.xml
ADDED
@@ -0,0 +1,255 @@
|
|
1
|
+
<!--
|
2
|
+
This file is part of the X12Parser library that provides tools to
|
3
|
+
manipulate X12 messages using Ruby native syntax.
|
4
|
+
|
5
|
+
http://x12parser.rubyforge.org
|
6
|
+
|
7
|
+
Copyright (C) 2012 P&D Technical Solutions, LLC
|
8
|
+
|
9
|
+
This library is free software; you can redistribute it and/or
|
10
|
+
modify it under the terms of the GNU Lesser General Public
|
11
|
+
License as published by the Free Software Foundation; either
|
12
|
+
version 2.1 of the License, or (at your option) any later version.
|
13
|
+
|
14
|
+
This library is distributed in the hope that it will be useful,
|
15
|
+
but WITHOUT ANY WARRANTY; without even the implied warranty of
|
16
|
+
MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the GNU
|
17
|
+
Lesser General Public License for more details.
|
18
|
+
|
19
|
+
You should have received a copy of the GNU Lesser General Public
|
20
|
+
License along with this library; if not, write to the Free Software
|
21
|
+
Foundation, Inc., 51 Franklin Street, Fifth Floor, Boston, MA 02110-1301 USA
|
22
|
+
|
23
|
+
$Id: 837p.xml 2012-11-23 mjp using version 5010 $
|
24
|
+
-->
|
25
|
+
|
26
|
+
<Definition>
|
27
|
+
<Loop name="837p" required="y">
|
28
|
+
<Segment name="ISA" max="1" required="y" />
|
29
|
+
<Segment name="GS" max="1" required="y" />
|
30
|
+
<Loop name="L837" max="5000" comment="This X12 Transaction Set contains the format and establishes the data contents of the Professional Healthcare Claim Transaction Set (837p) for use within the context of an Electronic Data Interchange (EDI) environment.">
|
31
|
+
<Segment name="ST" max="1" required="y" />
|
32
|
+
<Segment name="BHT" max="1" required="y" />
|
33
|
+
<Loop name="L1000A" max="1" required="y">
|
34
|
+
<Segment name="NM1" max="1" required="y" comment="Submitter EDI name"/>
|
35
|
+
<Segment name="PER" max="2" required="y" comment="Submitter EDI contact information"/>
|
36
|
+
</Loop>
|
37
|
+
<Loop name="L1000B" max="1" required="y">
|
38
|
+
<Segment name="NM1" max="1" required="y" comment="Receiver name"/>
|
39
|
+
</Loop>
|
40
|
+
<Loop name="L2000A" required="y">
|
41
|
+
<Segment name="HL" max="1" required="y" comment="Billing provider hierarchical level"/>
|
42
|
+
<Segment name="PRV" max="1" required="n" comment="Billing provider specialty information"/>
|
43
|
+
<Segment name="CUR" max="1" required="n" comment="Foreign currency information"/>
|
44
|
+
<Loop name="L2010AA" max="1" required="y">
|
45
|
+
<Segment name="NM1" max="1" required="y" comment="Billing provider name"/>
|
46
|
+
<Segment name="N3" max="1" required="y" comment="Billing provider address"/>
|
47
|
+
<Segment name="N4" max="1" required="y" comment="Billing provider city/state/zip code"/>
|
48
|
+
<Segment name="REF" max="1" required="y" comment="Billing provider tax id"/>
|
49
|
+
<Segment name="REF" max="2" required="n" comment="Billing provider upin/license information"/>
|
50
|
+
<Segment name="PER" max="2" required="n" comment="Billing provider contact information"/>
|
51
|
+
</Loop>
|
52
|
+
<Loop name="L2010AB" max="1" required="n">
|
53
|
+
<Segment name="NM1" max="1" required="y" comment="Pay-to address name"/>
|
54
|
+
<Segment name="N3" max="1" required="y" comment="Pay-to provider address"/>
|
55
|
+
<Segment name="N4" max="1" required="y" comment="Pay-to provider city/state/zip code"/>
|
56
|
+
<Segment name="REF" max="5" required="n" comment="Pay-to provider contact information"/>
|
57
|
+
</Loop>
|
58
|
+
<Loop name="L2010AC" max="1" required="n">
|
59
|
+
<Segment name="NM1" max="1" required="y" comment="Pay-to plan name"/>
|
60
|
+
<Segment name="N3" max="1" required="y" comment="Pay-to plan address"/>
|
61
|
+
<Segment name="N4" max="1" required="y" comment="Pay-to plan city/state/zip code"/>
|
62
|
+
<Segment name="REF" max="1" required="n" comment="Pay-to plan secondary id"/>
|
63
|
+
<Segment name="REF" max="1" required="y" comment="Pay-to plan tax id"/>
|
64
|
+
</Loop>
|
65
|
+
</Loop>
|
66
|
+
<Loop name="L2000B" required="y">
|
67
|
+
<Segment name="HL" max="1" required="y" comment="Subscriber heiarchical level"/>
|
68
|
+
<Segment name="SBR" max="1" required="y" comment="subscriber information"/>
|
69
|
+
<Segment name="PAT" max="1" required="n" comment="Patient information"/>
|
70
|
+
|
71
|
+
<Loop name="L2010BA" max="1" required="y">
|
72
|
+
<Segment name="NM1" max="1" required="y" comment="Subscriber name"/>
|
73
|
+
<Segment name="N3" max="1" required="n" comment="Subscriber address"/>
|
74
|
+
<Segment name="N4" max="1" required="n" comment="Subscriber city/state/zip"/>
|
75
|
+
<Segment name="DMG" max="1" required="n" comment="Subscriber demographic information"/>
|
76
|
+
<Segment name="REF" max="2" required="n"/>
|
77
|
+
<Segment name="PER" max="1" required="n" comment="Property and casualty subscriber contact information"/>
|
78
|
+
</Loop>
|
79
|
+
<Loop name="L2010BB" max="1" required="y">
|
80
|
+
<Segment name="NM1" max="1" required="y" comment="Payer name"/>
|
81
|
+
<Segment name="N3" max="1" required="n" comment="Payer address"/>
|
82
|
+
<Segment name="N4" max="1" required="n" comment="Payer city/state/zip code"/>
|
83
|
+
<Segment name="REF" max="5" required="n" />
|
84
|
+
</Loop>
|
85
|
+
</Loop>
|
86
|
+
<Loop name="L2000C" required="n">
|
87
|
+
<Segment name="HL" required="y" comment="Patient heirarchical level"/>
|
88
|
+
<Segment name="PAT" required="y" comment="Patient information"/>
|
89
|
+
<Loop name="L2010CA" max="1" required="n">
|
90
|
+
<Segment name="NM1" max="1" required="y" comment="Patient name"/>
|
91
|
+
<Segment name="N3" max="1" required="y" comment="Patient address"/>
|
92
|
+
<Segment name="N4" max="1" required="y" comment="Patient city/state/zip"/>
|
93
|
+
<Segment name="DMG" max="1" required="y" comment="Patient demographic information"/>
|
94
|
+
<Segment name="REF" max="1" required="n" comment="Property and casualty claim number"/>
|
95
|
+
<Segment name="PER" max="1" required="n" comment="Property and casualty subscriber contact information"/>
|
96
|
+
</Loop>
|
97
|
+
</Loop>
|
98
|
+
<Loop name="L2300" max="100" required="y">
|
99
|
+
<Segment name="CLM" max="1" required="y" comment="Claim information"/>
|
100
|
+
<Segment name="DTP" max="16" required="n" comment="Claim Dates. Up to 16 different dates can be set for a 837p" />
|
101
|
+
<Segment name="PWK" max="10" required="n" comment="Claim supplemental information" />
|
102
|
+
<Segment name="CN1" max="1" required="n" comment="Contract information" />
|
103
|
+
<Segment name="AMT" max="1" required="n" comment="Patient amount paid" />
|
104
|
+
<Segment name="REF" max="14" required="n" comment="Claim References. Up to 14 different claim references can be set for a 837p" />
|
105
|
+
<Segment name="K3" max="10" required="n" comment="File information" />
|
106
|
+
<Segment name="NTE" max="1" required="n" comment="Claim note" />
|
107
|
+
<Segment name="CR1" max="1" required="n" comment="Ambulance transport information" />
|
108
|
+
<Segment name="CR2" max="1" required="n" comment="Spinal manipulation service information" />
|
109
|
+
<Segment name="CRC" max="8" required="n" comment="Code Category. Up to 8 different CRC categories can be set for an 837p" />
|
110
|
+
<Segment name="HI" max="1" required="y" comment="Healthcare diagnostic code" />
|
111
|
+
<Segment name="HI" max="1" required="n" comment="Anesthesia related procedure code" />
|
112
|
+
<Segment name="HI" max="2" required="n" comment="Condition information" />
|
113
|
+
<Segment name="HCP" max="1" required="n" comment="Claim pricing / repricing information" />
|
114
|
+
|
115
|
+
<Loop name="L2310A" max="1" required="n">
|
116
|
+
<Segment name="NM1" max="1" required="y" comment="Referring provider name"/>
|
117
|
+
<Segment name="REF" max="3" required="n" comment="Referring provider secondary id"/>
|
118
|
+
</Loop>
|
119
|
+
<Loop name="L2310B" max="1" required="n">
|
120
|
+
<Segment name="NM1" max="1" required="n" comment="Rendering provider name"/>
|
121
|
+
<Segment name="PRV" max="1" required="n" comment="Rendering provider specialty information"/>
|
122
|
+
<Segment name="REF" max="4" required="n" comment="Rendering provider secondary id"/>
|
123
|
+
</Loop>
|
124
|
+
<Loop name="L2310C" required="n">
|
125
|
+
<Segment name="NM1" max="1" required="y" comment="Service facility location"/>
|
126
|
+
<Segment name="N3" max="1" required="y" comment="Service facility address"/>
|
127
|
+
<Segment name="N4" max="1" required="y" comment="Service facility city/state/zip"/>
|
128
|
+
<Segment name="REF" max="3" required="n" comment="Service facility location secondary id"/>
|
129
|
+
<Segment name="PER" max="1" required="n" comment="Service facility contact information"/>
|
130
|
+
</Loop>
|
131
|
+
<Loop name="L2310D" max="1" required="n">
|
132
|
+
<Segment name="NM1" max="1" required="n" comment="Supervising provider name"/>
|
133
|
+
<Segment name="REF" max="4" required="n" comment="Supervising provider secondary id"/>
|
134
|
+
</Loop>
|
135
|
+
<Loop name="L2310E" max="1" required="n">
|
136
|
+
<Segment name="NM1" max="1" required="y" comment="Ambulance pick up location"/>
|
137
|
+
<Segment name="N3" max="1" required="y" comment="Ambulance pick up address"/>
|
138
|
+
<Segment name="N4" max="1" required="y" comment="Ambulance pick up city/state/zip"/>
|
139
|
+
</Loop>
|
140
|
+
<Loop name="L2310F" max="1" required="n">
|
141
|
+
<Segment name="NM1" max="1" required="y" comment="Ambulance dropoff location"/>
|
142
|
+
<Segment name="N3" max="1" required="y" comment="Ambulance dropoff address"/>
|
143
|
+
<Segment name="N4" max="1" required="y" comment="Ambulance dropoff city/state/zip"/>
|
144
|
+
</Loop>
|
145
|
+
<Loop name="L2320" max="10" required="n">
|
146
|
+
<Segment name="SBR" max="1" required="n" comment="Other subscriber information" />
|
147
|
+
<Segment name="CAS" max="5" required="n" comment="Claim level adjustment" />
|
148
|
+
<Segment name="AMT" max="3" required="n" comment="Claim level adjustment amounts" />
|
149
|
+
<Segment name="OI" max="1" required="y" comment="Other insurance coverage information" />
|
150
|
+
<Segment name="MOA" max="1" required="n" comment="Medicare outpatient adjudication information" />
|
151
|
+
</Loop>
|
152
|
+
<Loop name="L2330A" max="1" required="n">
|
153
|
+
<Segment name="NM1" max="1" required="y" comment="Other subscriber name"/>
|
154
|
+
<Segment name="N3" max="1" required="n" comment="Other subscriber address"/>
|
155
|
+
<Segment name="N4" max="1" required="y" comment="Other subscriber city/state/zip"/>
|
156
|
+
<Segment name="REF" max="1" required="n" comment="Other subscriber location secondary id"/>
|
157
|
+
</Loop>
|
158
|
+
<Loop name="L2330B" max="1" required="n">
|
159
|
+
<Segment name="NM1" max="1" required="y" comment="Other payer name" />
|
160
|
+
<Segment name="N3" max="1" required="n" comment="Other payer address"/>
|
161
|
+
<Segment name="N4" max="1" required="y" comment="Other payer city/state/zip"/>
|
162
|
+
<Segment name="DTP" max="1" required="n" comment="Date - claim check or remittance date" />
|
163
|
+
<Segment name="REF" max="6" required="n" comment="Other reference information. Up to 6 different references can be associated to an 837p" />
|
164
|
+
</Loop>
|
165
|
+
<Loop name="L2330CDEFG" max="6" required="n" comment="Loops 2330C through 2330G combined for inbound transactions, application needs to determine the correct loop being provided.">
|
166
|
+
<Segment name="NM1" max="1" required="y" comment="Name" />
|
167
|
+
<Segment name="REF" max="3" required="y" comment="Secondary id"/>
|
168
|
+
</Loop>
|
169
|
+
<Loop name="L2400" max="50" required="y">
|
170
|
+
<Segment name="LX" max="1" required="y" comment="Service line" />
|
171
|
+
<Segment name="SV1" max="1" required="y" comment="Professional service" />
|
172
|
+
<Segment name="SV5" max="1" required="n" comment="Durable medical equipment service" />
|
173
|
+
<Segment name="PWK" max="10" required="n" comment="Line supplemental informtion" />
|
174
|
+
<Segment name="PWK" max="1" required="n" comment="Durable medical equipment certificate of medical necessity indicator" />
|
175
|
+
<Segment name="CR1" max="1" required="n" comment="Ambulance transport information" />
|
176
|
+
<Segment name="CR3" max="1" required="n" comment="Durable medical equipment certification" />
|
177
|
+
<Segment name="CRC" max="3" required="n" comment="Ambulance certification" />
|
178
|
+
<Segment name="CRC" max="1" required="n" comment="Hospice employee indicator" />
|
179
|
+
<Segment name="CRC" max="1" required="n" comment="Condition indicator durable medical equipment" />
|
180
|
+
<Segment name="DTP" max="1" required="y" comment="Date - service date; qualifier=472" />
|
181
|
+
<Segment name="DTP" max="9" required="n" />
|
182
|
+
<Segment name="QTY" max="1" required="n" comment="Ambulance patient count; qualifier=PT" />
|
183
|
+
<Segment name="QTY" max="1" required="n" comment="Obstetric Anesthesia additional units; qualifier=FL" />
|
184
|
+
<Segment name="MEA" max="5" required="n" comment="Test Results" />
|
185
|
+
<Segment name="CN1" max="1" required="n" comment="Contract information" />
|
186
|
+
<Segment name="REF" max="17" required="n" />
|
187
|
+
<Segment name="AMT" max="2" required="n" />
|
188
|
+
<Segment name="K3" max="10" required="n" comment="File information" />
|
189
|
+
<Segment name="NTE" max="2" required="n" />
|
190
|
+
<Segment name="PS1" max="1" required="n" comment="Purchasd service information" />
|
191
|
+
<Segment name="HCP" max="1" required="n" comment="Line pricing/repricing information" />
|
192
|
+
</Loop>
|
193
|
+
<Loop name="L2410" max="1" required="n" >
|
194
|
+
<Segment name="LIN" max="1" required="n" comment="Drug identification" />
|
195
|
+
<Segment name="CTP" max="1" required="y" comment="Drug pricing" />
|
196
|
+
<Segment name="REF" max="1" required="n" comment="Prescription or compound drug association number" />
|
197
|
+
</Loop>
|
198
|
+
<Loop name="L2420A" max="1" required="n" >
|
199
|
+
<Segment name="NM1" max="1" required="n" comment="Rendering provider name" />
|
200
|
+
<Segment name="PRV" max="1" required="n" comment="Rendering provider specialty information" />
|
201
|
+
<Segment name="REF" max="20" required="n" comment="Rendering provider secondary id" />
|
202
|
+
</Loop>
|
203
|
+
<Loop name="L2420B" max="1" required="n" >
|
204
|
+
<Segment name="NM1" max="1" required="n" comment="Purchased service provider name" />
|
205
|
+
<Segment name="REF" max="20" required="n" comment="Purchased service provider secondary id" />
|
206
|
+
</Loop>
|
207
|
+
<Loop name="L2420C" max="1" required="n" >
|
208
|
+
<Segment name="NM1" max="1" required="n" comment="Service facility location name" />
|
209
|
+
<Segment name="N3" max="1" required="y" comment="Service facility location address" />
|
210
|
+
<Segment name="N4" max="1" required="y" comment="Service facility location city/state/zip" />
|
211
|
+
<Segment name="REF" max="3" required="n" comment="Service facility location secondary id" />
|
212
|
+
</Loop>
|
213
|
+
<Loop name="L2420D" max="1" required="n">
|
214
|
+
<Segment name="NM1" max="1" required="n" comment="Supervising provider name" />
|
215
|
+
<Segment name="REF" max="20" required="n" comment="Supervising provider secondary id" />
|
216
|
+
</Loop>
|
217
|
+
<Loop name="L2420E" required="n">
|
218
|
+
<Segment name="NM1" max="1" required="n" comment="Ordering provider name" />
|
219
|
+
<Segment name="N3" max="1" required="n" comment="Ordering provider address" />
|
220
|
+
<Segment name="N4" max="1" required="y" comment="Ordering provider city/state/zip" />
|
221
|
+
<Segment name="REF" max="20" required="n" comment="Ordering provider secondary id" />
|
222
|
+
<Segment name="PER" max="1" required="n" comment="Ordering provider contact information" />
|
223
|
+
</Loop>
|
224
|
+
<Loop name="L2420F" max="2" required="n">
|
225
|
+
<Segment name="NM1" max="1" required="n" comment="Refering provider name" />
|
226
|
+
<Segment name="REF" max="20" required="n" comment="Refering provider secondary id" />
|
227
|
+
</Loop>
|
228
|
+
<Loop name="L2420G" max="1" required="n">
|
229
|
+
<Segment name="NM1" max="1" required="n" comment="Ambulance pickup information" />
|
230
|
+
<Segment name="N3" max="1" required="y" comment="Ambulance pickup address" />
|
231
|
+
<Segment name="N4" max="1" required="y" comment="Ambulance pickup city/state/zip" />
|
232
|
+
</Loop>
|
233
|
+
<Loop name="L2420H" max="1" required="n">
|
234
|
+
<Segment name="NM1" max="1" required="n" comment="Ambulance dropoff information" />
|
235
|
+
<Segment name="N3" max="1" required="y" comment="Ambulance dropoff address" />
|
236
|
+
<Segment name="N4" max="1" required="y" comment="Ambulance dropoff city/state/zip" />
|
237
|
+
</Loop>
|
238
|
+
<Loop name="L2430" max="15" required="n">
|
239
|
+
<Segment name="SVD" max="1" required="n" comment="Line adjudication information" />
|
240
|
+
<Segment name="CAS" max="5" required="n" comment="Line adjustment" />
|
241
|
+
<Segment name="DTP" max="1" required="y" comment="Line check or remittance date" />
|
242
|
+
<Segment name="AMT" max="1" required="n" comment="Remaining patient liability" />
|
243
|
+
<Segment name="LQ" max="1" required="n" comment="Form identification code" />
|
244
|
+
<Segment name="FRM" max="99" required="n" comment="Supporting documentation" />
|
245
|
+
</Loop>
|
246
|
+
</Loop>
|
247
|
+
<Segment name="SE" required="y" />
|
248
|
+
</Loop>
|
249
|
+
<Segment name="GE" max="1" required="y"/>
|
250
|
+
<Segment name="IEA" max="1" required="y"/>
|
251
|
+
</Loop>
|
252
|
+
</Definition>
|
253
|
+
|
254
|
+
|
255
|
+
|
data/misc/850.xml
ADDED
@@ -0,0 +1,66 @@
|
|
1
|
+
<!--
|
2
|
+
This file is part of the X12Parser library that provides tools to
|
3
|
+
manipulate X12 messages using Ruby native syntax.
|
4
|
+
|
5
|
+
Copyright (C) 2013 P&D Technology Solutions, LLC.
|
6
|
+
|
7
|
+
This library is free software; you can redistribute it and/or
|
8
|
+
modify it under the terms of the GNU Lesser General Public
|
9
|
+
License as published by the Free Software Foundation; either
|
10
|
+
version 2.1 of the License, or (at your option) any later version.
|
11
|
+
|
12
|
+
This library is distributed in the hope that it will be useful,
|
13
|
+
but WITHOUT ANY WARRANTY; without even the implied warranty of
|
14
|
+
MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the GNU
|
15
|
+
Lesser General Public License for more details.
|
16
|
+
|
17
|
+
You should have received a copy of the GNU Lesser General Public
|
18
|
+
License along with this library; if not, write to the Free Software
|
19
|
+
Foundation, Inc., 51 Franklin Street, Fifth Floor, Boston, MA 02110-1301 USA
|
20
|
+
|
21
|
+
$Id: 850dsd.xml 85 2013-03-22 19:17:51Z mjp $
|
22
|
+
-->
|
23
|
+
|
24
|
+
<Definition>
|
25
|
+
<Loop name="850" comment="This X12 Transaction Set contains the format and establishes the data contents of the Functional Acknowledgment Transaction Set (850) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to define the control structures for a set of acknowledgments to indicate the results of the syntactical analysis of the electronically encoded documents. The encoded documents are the transaction sets, which are grouped in functional groups, used in defining transactions for business data interchange. This standard does not cover the semantic meaning of the information encoded in the transaction sets.">
|
26
|
+
<Segment name="ISA" max="1" required="y" />
|
27
|
+
<Segment name="GS" max="1" required="y" />
|
28
|
+
<Segment name="ST" max="1" required="y">
|
29
|
+
<Field name="TransactionSetIdentifierCode" const="850" min="3" max="3" comment="Code uniquely identifying a Transaction Set"/>
|
30
|
+
<Field name="TransactionSetControlNumber" min="4" max="9" comment="Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set"/>
|
31
|
+
</Segment>
|
32
|
+
<Segment name="BEG" max="1" required="y" comment="Beginning segment for purchase order" />
|
33
|
+
<Segment name="PER" max="3" required="n" comment="Administrative communication contact" />
|
34
|
+
<Segment name="FOB" max="inf" required="n" comment="FOB related instructions" />
|
35
|
+
<Segment name="DTM" max="10" required="n" comment="Date/Time Reference" />
|
36
|
+
<Segment name="PKG" max="200" required="n" comment="Marking, Packaging, Loading" />
|
37
|
+
<Segment name="TD5" max="inf" required="n" comment="Carrier details (routing sequence / transit time)" />
|
38
|
+
<Loop name="N9" max="1000" required="n">
|
39
|
+
<Segment name="N9" max="1" required="n" comment="Extended reference information" />
|
40
|
+
<Segment name="MTX" max="inf" required="n" comment="Text" />
|
41
|
+
</Loop>
|
42
|
+
<Loop name="N1" max="200" required="n">
|
43
|
+
<Segment name="N1" max="1" required="n" comment="Party identification" />
|
44
|
+
<Segment name="N3" max="2" required="n" comment="Party location" />
|
45
|
+
<Segment name="N4" max="inf" required="n" comment="Geographic location" />
|
46
|
+
</Loop>
|
47
|
+
<Loop name="PO1" max="100000">
|
48
|
+
<Segment name="PO1" max="1" required="y" comment="Baseline item detail" />
|
49
|
+
<Loop name="PID" max="1000" required="n">
|
50
|
+
<Segment name="PID" max="1" required="n" comment="Product/item description" />
|
51
|
+
</Loop>
|
52
|
+
<Segment name="PO4" max="inf" required="n" comment="Item physical details" />
|
53
|
+
<Loop segment="SAC" max="25" required="n">
|
54
|
+
<Segment name="SAC" max="1" required="n" comment="Service, promotion, allowance or charge information" />
|
55
|
+
</Loop>
|
56
|
+
<Segment name="TAX" max="inf" required="n" comment="Tax reference" />
|
57
|
+
</Loop>
|
58
|
+
<Loop segment="CTT">
|
59
|
+
<Segment name="CTT" max="1" required="n" comment="Transaction totals" />
|
60
|
+
<Segment name="AMT" max="1" required="n" comment="Monetary Amount" />
|
61
|
+
</Loop>
|
62
|
+
<Segment name="SE" max="1" required="y"/>
|
63
|
+
<Segment name="GE" max="1" required="y"/>
|
64
|
+
<Segment name="IEA" max="1" required="y"/>
|
65
|
+
</Loop>
|
66
|
+
</Definition>
|
data/misc/850dsd.xml
ADDED
@@ -0,0 +1,59 @@
|
|
1
|
+
<!--
|
2
|
+
This file is part of the X12Parser library that provides tools to
|
3
|
+
manipulate X12 messages using Ruby native syntax.
|
4
|
+
|
5
|
+
Copyright (C) 2013 P&D Technology Solutions, LLC.
|
6
|
+
|
7
|
+
This library is free software; you can redistribute it and/or
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modify it under the terms of the GNU Lesser General Public
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License as published by the Free Software Foundation; either
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version 2.1 of the License, or (at your option) any later version.
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This library is distributed in the hope that it will be useful,
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but WITHOUT ANY WARRANTY; without even the implied warranty of
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MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the GNU
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Lesser General Public License for more details.
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You should have received a copy of the GNU Lesser General Public
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License along with this library; if not, write to the Free Software
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Foundation, Inc., 51 Franklin Street, Fifth Floor, Boston, MA 02110-1301 USA
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$Id: 850dsd.xml 85 2013-03-22 19:17:51Z mjp $
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-->
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<Definition>
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<Loop name="850" comment="This X12 Transaction Set contains the format and establishes the data contents of the Functional Acknowledgment Transaction Set (850) for use within the context of an Electronic Data Interchange (EDI) environment. The transaction set can be used to define the control structures for a set of acknowledgments to indicate the results of the syntactical analysis of the electronically encoded documents. The encoded documents are the transaction sets, which are grouped in functional groups, used in defining transactions for business data interchange. This standard does not cover the semantic meaning of the information encoded in the transaction sets.">
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<Segment name="ISA" max="1" required="y" />
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<Segment name="GS" max="1" required="y" />
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<Segment name="ST" max="1" required="y">
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<Field name="TransactionSetIdentifierCode" const="850" min="3" max="3" comment="Code uniquely identifying a Transaction Set"/>
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<Field name="TransactionSetControlNumber" min="4" max="9" comment="Identifying control number that must be unique within the transaction set functional group assigned by the originator for a transaction set"/>
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</Segment>
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<Segment name="BEG" max="1" required="y" comment="Beginning segment for purchase order" />
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<Segment name="DTM" max="10" required="n" comment="Date/Time Reference" />
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<Loop name="N9" max="1000" required="n">
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<Segment name="N9" max="1" required="n" comment="Extended reference information" />
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</Loop>
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<Loop name="N1" max="200" required="n">
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<Segment name="N1" max="1" required="n" comment="Party identification" />
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<Segment name="N3" max="2" required="n" comment="Party location" />
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<Segment name="N4" max="inf" required="n" comment="Geographic location" />
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</Loop>
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<Loop name="PO1" max="100000">
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<Segment name="PO1" max="1" required="y" comment="Baseline item detail" />
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<Loop name="PID" max="1000">
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<Segment name="PID" max="1" required="n" comment="Product/item description" />
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</Loop>
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<Segment name="PO4" max="inf" required="n" comment="Item physical details" />
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<Loop segment="N9" max="1000">
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<Segment name="N9" max="1" required="n" comment="Extended reference information" />
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</Loop>
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</Loop>
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<Loop segment="CTT">
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<Segment name="CTT" max="1" required="n"comment="Transaction totals" />
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</Loop>
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<Segment name="SE" max="1" required="y"/>
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<Segment name="GE" max="1" required="y"/>
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<Segment name="IEA" max="1" required="y"/>
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</Loop>
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</Definition>
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