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Value Information Group Definition
Format-Length:   Required For:  See Below
Effective Date:  1/1/94 Revision Date:  September 2003

NOTE: This is a composite data element. Up to 12 Value Codes and Amounts can be reported. For mapping guidelines refer to the Inpatient and Outpatient 837 Addenda.

National Standard Mapping:

Electronic - 837I

X12 Loop

Ref. Des.

Data Element

Code

Description
Version 4050R 2300 HI01-1 1270 BE Value Code Qualifier
HI01-2 1271 Value Code
HI01-5 782 Value Code Associated Amount

Paper Form Locator Code Qualifier
Institutional - UB-04 39-41 N/A

Definition:

A code structure to relate amounts or values to identified data elements necessary to process this claim as qualified by the payer organization. The elements listed below are collected by SPARCS as Value Codes.

Ambulatory Surgery Only:
Accident Hour
Emergency Department Only:
Accident Hour
Inpatient Only:
Workers' Compensation/No-Fault Indicator
Surplus, Catastrophic, or Recurring Monthly Income Code and Amount
Blood Furnished Code and Amount
Neonate Birth Weight
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