SVD Service Line Adjudication
SVD Service Line Adjudication
To convey service line adjudication information for coordination of benefits between the initial payers of a health care claim and all subsequent payers
Position
Element
Name
Type
Requirement
Min
Max
Repeat
SVD-01
Identification Code
String (AN)
Mandatory
2
80
-
Code identifying a party or other code
SVD01 is the payer identification code.
SVD-02
Monetary Amount
Decimal number (R)
Mandatory
1
18
-
Monetary amount
SVD02 is the amount paid for this service line.
SVD-03
Optional
-
SVD03 represents the medical procedure code upon which adjudication of this service line was based. This may be different than the submitted medical procedure code.
SVD-04
Product/Service ID
String (AN)
Optional
1
48
-
Identifying number for a product or service
SVD04 is the revenue code.
SVD-05
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity
SVD05 is the paid units of service.
SVD-06
Assigned Number
Numeric (N0)
Optional
1
6
-
Number assigned for differentiation within a transaction set
SVD06 is only used for bundling of service lines. It references the LX Assigned Number of the service line into which this service line was bundled.