Wisconsin Medicaid Companion Document to HIPAA
Implementation Guide — 837 Institutional
837 Institutional V5
PHC 13067 (4/08)
Revision Log
PDF (225 KB)
Appendix 2 — Assigned Contract Information Segment Value Codes
|
HOSPITAL SPECIFIC CN1 VALUES |
|
Services |
Contract Information Segment (CN1) Value Codes
|
| Acute Care
for AIDS |
01 |
| Extended Care
for AIDS |
02 |
| Ventilator
Long-Term Services |
04 |
| Critical
Access |
10 |
| Brain Injury |
80 |
| Brain Injury
Neural Behavior |
81 |
| Brain
Injury-Coma Stem |
82 |
|
BILLING |
|
Provider Type |
CN1 Value Codes |
| Case
Management |
CM |
| Community
Support Program |
CS |
| Comprehensive
Community Services |
CC |
| Crisis
Intervention |
C1 |
| Prenatal Care
Coordination |
PN |
| Substance
Abuse Day Treatment |
21 |
| Adult Mental
Health Day Treatment |
26 |
|
RENDERING |
|
Provider Type |
CN1 Value Codes |
| Community
Support Program |
CSR |
| Comprehensive
Community Services |
CCR |
| Crisis
Intervention |
C1R |
Back to the beginning of this Companion
Document
X12 837 Institutional Health Care Claim
Appendix 1 — Examples
Appendix 3 — BadgerCare Plus Required Taxonomy
Codes
Back to Companion
Documents
| 
