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| Data Element Name: Inpatient Ancillary Services Information Group Definition | File Location: Master, De-Identified |
| SPARCS Data Element Number: 65 - 67 | |
| Record Positions: 847 - 1326 | Format-Length: A/N - 24 |
| Effective Date: 1/1/1994 | Revision Date: |
| Deniable Data Element: No | |
The following block of data represents ancillary information reported on the bill in one to twenty occurrences. The codes were entered in ascending numerical order with common ancillary codes grouped where possible.
If more than twenty Ancillary Service Codes were reported for a patient stay, overflow records were used to record this data. See Record Sequence Number (Data elements 8), Sequence Count (Data elements 9), and Appendix ZZ Multiple Record Discharges .
It is necessary to report at least one SPARCS Accommodation or one Ancillary Service with each claim.
| Data Element Number | Data Element Name | Occurrence | Record Positions |
| 65 | Ancillary Revenue Code | 1 | 847 - 850 |
| 2 | 871 - 874 | ||
| 3 | 895 - 898 | ||
| 4 | 919 - 922 | ||
| 5 | 943 - 946 | ||
| 6 | 967 - 970 | ||
| 7 | 991 - 994 | ||
| 8 | 1,015 - 1,018 | ||
| 9 | 1,039 - 1,042 | ||
| 10 | 1,063 - 1,066 | ||
| 11 | 1,087 - 1,090 | ||
| 12 | 1,111 - 1,114 | ||
| 13 | 1,135 - 1,138 | ||
| 14 | 1,159 - 1,162 | ||
| 15 | 1,183 - 1,186 | ||
| 16 | 1,207 - 1,210 | ||
| 17 | 1,231 - 1,234 | ||
| 18 | 1,255 - 1,258 | ||
| 19 | 1,279 - 1,282 | ||
| 20 | 1,303 - 1,306 |
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| 66 | Ancillary Total Charges | 1 | 851 - 860 |
| 2 | 875 - 884 | ||
| 3 | 899 - 908 | ||
| 4 | 923 - 932 | ||
| 5 | 947 - 956 | ||
| 6 | 971 - 980 | ||
| 7 | 995 - 1004 | ||
| 8 | 1,019 - 1,028 | ||
| 9 | 1,043 - 1,052 | ||
| 10 | 1,067 - 1,076 | ||
| 11 | 1,091 - 1,100 | ||
| 12 | 1,115 - 1,124 | ||
| 13 | 1,139 - 1,148 | ||
| 14 | 1,163 - 1,172 | ||
| 15 | 1,187 - 1,196 | ||
| 16 | 1,211 - 1,220 | ||
| 17 | 1,235 - 1,244 | ||
| 18 | 1,259 - 1,268 | ||
| 19 | 1,283 - 1,292 | ||
| 20 | 1,307 - 1,316 |
||
| 67 | Ancillary Total Non-Covered Charges | 1 | 861 - 870 |
| 2 | 885 - 894 | ||
| 3 | 909 - 918 | ||
| 4 | 933 - 942 | ||
| 5 | 957 - 966 | ||
| 6 | 981 - 990 | ||
| 7 | 1,005 - 1,014 | ||
| 8 | 1,029 - 1,038 | ||
| 9 | 1,053 - 1,062 | ||
| 10 | 1,077 - 1,086 | ||
| 11 | 1,101 - 1,110 | ||
| 12 | 1,125 - 1,134 | ||
| 13 | 1,149 - 1,158 | ||
| 14 | 1,173 - 1,182 | ||
| 15 | 1,197 - 1,206 | ||
| 16 | 1,221 - 1,230 | ||
| 17 | 1,245 - 1,254 | ||
| 18 | 1,269 - 1,278 | ||
| 19 | 1,293 - 1,302 | ||
| 20 | 1,317 - 1,326 |
