ISA15 M Usage Indicator Production 1/1 “P” Test “T” ISA16 M Component element separator 1/1 “: “ GS Functional Group Header – Usage : Mandatory Segment Max Use Within : 1 Repeat : NONE Loop ID : NONE Example: GS*BE*xxxxx4321*xxxxx0123*20120101*1452*000000001*X*005010X220~ Min/Max Segment Usage Name Values Description Length GS01 M Functional Identifier Code Benefit Enrollment and Maintenance 2/2. “BE” GS02 M Application Senders Code Senders ID 2/15 GS03 M Application Code See Duns in Supplement 2/15 Receiver’s GS04 M Date CCYYMMDD 8/8 GS05 M Time HHMM 4/4 GS06 M Group Control Number Must match the control number of the 1/9 GE02 element GS07 M Responsibility Agency Code Accredited Standards Committee X12 1/2 “X” GS08 M Version/Release/Industry Identifier 1/12 “005010X220” Code ST Transaction Set Header – Usage : Mandatory Segment Max Use Within : 1 Repeat : NONE Loop ID : NONE Example: ST*834*0001~ Min/Max Segment Usage Name Values Description Length ST01 M Transaction Set Identifier Code Eligibility coverage or benefit inquiry 3/3 “834” ST02 M Transaction Set Control Number Identifying control number that must be 4/9 unique within the transaction set functional group assigned by the originator for a transaction set. The transaction set control numbers in and must be identical. This COMMENT: ST02 SE02 unique number also aids in error resolution research. Start with the number, for example “0001”,
ISA15 M Usage Indicator “P” Production 1/1 “T” Test ISA16 M Component element separator “: “ 1/1 GS – Functional Group Header Usage : Mandatory Segment Max Use Within : 1 Repeat : NONE Loop ID : NONE Example: GS*BE*xxxxx4321*xxxxx0123*20120101*1452*000000001*X*005010X220~ Min/Max Segment Usage Name Values Description Length GS01 M Functional Identifier Code “BE” Benefit Enrollment and Maintenance 2/2. GS02 M Application Senders Code Senders ID 2/15 GS03 M Application Receiver’s Code See Duns in Supplement 2/15 GS04 M Date CCYYMMDD 8/8 GS05 M Time HHMM 4/4 GS06 M Group Control Number Must match the control number of the 1/9 GE02 element GS07 M Responsibility Agency Code “X” Accredited Standards Committee X12 1/2 GS08 M Version/Release/Industry Identifier “005010X220” 1/12 Code ST – Transaction Set Header Usage : Mandatory Segment Max Use Within : 1 Repeat : NONE Loop ID : NONE Example: ST*834*0001~ Min/Max Segment Usage Name Values Description Length ST01 M Transaction Set Identifier Code “834” Eligibility coverage or benefit inquiry 3/3 ST02 M Transaction Set Control Number Identifying control number that must be 4/9 unique within the transaction set functional group assigned by the originator for a transaction set. COMMENT: The transaction set control numbers in ST02 and SE02 must be identical. This unique number also aids in error resolution research. Start with the number, for example “0001”,
834_05010_MAPPING_SPECIFICATIONS_1_.docx