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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

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