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ADI -

Health care claim adjudication information
UN/CEFACT Revision 2000A Segment List

Function:To provide adjudication information for all services in a health care claim.
This segment also occurs in the following versions of this standard:
D99B, D00A, D00B, D01A, D01B, D01C, D02A, D02B, D03A, D03B, D04A, D04B

Pos Segment M/C Repeat Repr. Notes
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..3
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 request/notification description 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 value 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

PosPosition
M/CMandatory or Conditional
Repr.Representation (Data or Content Type)

Segment ADI is used in the following messages:
IHCLME

Change indicators
plus sign An addition.
asterisk Addition/substraction/change to a code entry for a particular data element.
hash or pound sign Changes to names.
vertical bar Changes to text for descriptions, notes and functions.
minus sign A deletion.
letter X Marked for deletion.

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