UB1 segment
The UB1 segment contains the data necessary to complete UB82 bills specific to the United States; other realms may choose to implement using regional code sets. Only UB82 fields that do not exist in other HL7 defined segments appear in this segment. Patient Name and Date of Birth are required for UB82 billing; however, they are included in the PID segment and therefore do not appear here. The UB codes listed as examples are not an exhaustive or current list. Refer to a UB specification for additional information. The Uniform Billing segments are specific to the US and may not be implemented in non-US systems.
The shape of one line
optional kept for older systems, still counted
UB1-4 and its value arrives as UB1-3, so the receiver stores Blood Replaced-Pints as Blood Furnished-Pints Of.This page carries the UB1 field table as published and nothing beyond it. The field notes, vendor behaviour, FHIR mapping and parsing guidance that thePID page has are still to be written for UB1.
Every field
| SEQ | LEN | DT | OPT | RP/# | TBL# | ITEM# | Element name | Cardinality |
|---|---|---|---|---|---|---|---|---|
| UB1-1 | 4 | SI | O | 00530 | Set ID - UB1 | 0..1 | ||
| UB1-2 | 1 | NM | B | 00531 | Blood Deductible (43) deprecated | 0..1 | ||
| UB1-3 | 2 | NM | O | 00532 | Blood Furnished-Pints Of (40) | 0..1 | ||
| UB1-4 | 2 | NM | O | 00533 | Blood Replaced-Pints (41) | 0..1 | ||
| UB1-5 | 2 | NM | O | 00534 | Blood Not Replaced-Pints(42) | 0..1 | ||
| UB1-6 | 2 | NM | O | 00535 | Co-Insurance Days (25) | 0..1 | ||
| UB1-7 | 14 | IS | O | Y/5 | 0043 | 00536 | Condition Code (35-39) | 0..5 |
| UB1-8 | 3 | NM | O | 00537 | Covered Days - (23) | 0..1 | ||
| UB1-9 | 3 | NM | O | 00538 | Non Covered Days - (24) | 0..1 | ||
| 41 | UVC | O | Y/8 | 00539 | Value Amount & Code (46-49) | 0..8 | ||
| ||||||||
| UB1-11 | 2 | NM | O | 00540 | Number Of Grace Days (90) | 0..1 | ||
| 250 | CE | O | 0348 | 00541 | Special Program Indicator (44) | 0..1 | ||
| ||||||||
| 250 | CE | O | 0349 | 00542 | PSRO/UR Approval Indicator (87) | 0..1 | ||
| ||||||||
| UB1-14 | 8 | DT | O | 00543 | PSRO/UR Approved Stay-Fm (88) | 0..1 | ||
| UB1-15 | 8 | DT | O | 00544 | PSRO/UR Approved Stay-To (89) | 0..1 | ||
| 259 | OCD | O | Y/5 | 00545 | Occurrence (28-32) | 0..5 | ||
| ||||||||
| 250 | CE | O | 0351 | 00546 | Occurrence Span (33) | 0..1 | ||
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| UB1-18 | 8 | DT | O | 00547 | Occur Span Start Date(33) | 0..1 | ||
| UB1-19 | 8 | DT | O | 00548 | Occur Span End Date (33) | 0..1 | ||
| UB1-20 | 30 | ST | B | 00549 | UB-82 Locator 2 deprecated | 0..1 | ||
| UB1-21 | 7 | ST | B | 00550 | UB-82 Locator 9 deprecated | 0..1 | ||
| UB1-22 | 8 | ST | B | 00551 | UB-82 Locator 27 deprecated | 0..1 | ||
| UB1-23 | 17 | ST | B | 00552 | UB-82 Locator 45 deprecated | 0..1 | ||
Related
Message types carrying UB1
UB1 appears in 6 message structures, belonging to 3 message types.