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ITC -

Institutional claim
UN/CEFACT Revision 2004A Segment List

Function:To provide specific claim information for services performed while admitted to an institution.
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 E027 INVOICE TYPE M 1
9631 Invoice type code M an..3
2013 Frequency code C an..3
020 6060 Quantity M 4 an..35
030 E026 ADMISSION M 1
9445 Admission type description code C an..3
9627 Admission source code C an..3
040 9447 Discharge type description code M 1 an..3
050 E025 BASIS OF SERVICE INFORMATION C 9
9641 Service basis code qualifier M an..3
7135 Product identifier M an..35
1131 Code list identification code C an..17
2380 Date or time or period text C an..35
2379 Date or time or period format code C an..3
5004 Monetary amount C n..35

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

Segment ITC 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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