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Data Element Name:  Other Procedure Code 1 - 14
Format-Length:  A/N - 7 Required For:  IP
Effective Date:  1/1/94 Revision Date:  January 2008

NOTE: This is a composite data element. Up to 24 Other Procedure Codes can be reported; however, SPARCS currently only processes the first fourteen (14) Other Procedure Codes. For mapping guidelines refer to the Inpatient 837 Addendum.

National Standard Mapping:

Electronic - 837I

X12 Loop

Ref. Des.

Data Element

Code

Description
Version 4050R 2300 HI01-1 1270 BQ Procedure Qualifier
HI01-2 1271 Other Procedure Code

Paper Form Locator Code Qualifier
Institutional - UB-04 74a-e N/A

Definition:

All significant procedures other than the Principal Procedure Code are to be reported here, as space allows. They are reported in order of significance, starting with the most significant.

A significant procedure is one that is surgical in nature, carries a procedural risk, carries an anesthetic risk, or requires specialized training. Surgery includes incision, excision, amputation, introduction, endoscopy, repair, destruction, suture, and manipulation.

Codes and Values:

  1. Must be entered exactly as shown in the ICD-9-CM coding reference.

  2. If this field is not applicable it must be blank.

Example: HI*BQ:3963:D8:20060413*BQ:3964:D8:20060413~

Edit Applications:

  1. If Other Procedure Code 1-14 is entered the corresponding Other Procedure Date 1-14 must also be reported.

  2. Edits pertaining to ICD-9-CM codes are validated on the basis of the Statement-Covers-Thru Date and Expected Principal Reimbursement depending on conditions described in Appendix N, which include sex-specific procedure code conditions.

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