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Data Element Name:  Condition Information - Special Program (PHC)
Format-Length:  A/N - 2 Required For:  IP
Effective Date:  1/1/94 Revision Date:  September 2003

NOTE: This is a composite data element. Up to 24 Condition Codes can be reported. 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 BG Condition Qualifier
HI01-2 1271 Condition Code

Paper Form Locator Code Qualifier
Institutional - UB-04 18-28 N/A

Definition:

The code which indicates if the patient is entitled to Medicaid benefits due to a specified physical impairment or treatment under the Physically Handicapped Children's (PHC) Program.

Codes and Values:

  1. A2 = Physically Handicapped Children's Program

Edit Applications:

  1. Must be a valid entry.
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