2300 Health care diagnosis code
One of the main purposes of 5010 is to support the upcoming change to ICD-10 diagnosis and procedure codes – a change providers must make by October 1, 2013. To help prepare for ICD-10, 5010 now requires a Diagnosis Code on all claims, and the maximum number of Diagnosis Codes was increased from eight in 4010 to 12 in 5010. Although you can report 12 diagnosis codes at the claim level, you can only point or link four codes to a specific service at the service line level.
| Loop | Seg ID | Segment Name | Format | Length | Ref# | Req | Value |
| 2300 | HI | Health care Diagnosis code | ID | 2 | R | HI | |
| Element Separator | AN | 1 | * | ||||
| HI01-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BK = Principal Diagnosis | |
| Component Element separator | 1 | : | |||||
| HI01-2 | Industry Code | AN | 1/30 | 1271 | R | Print Primary Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI02-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis Code | |
| Component Element separator | 1 | : | |||||
| HI02-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI03-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis Code | |
| Component Element separator | 1 | : | |||||
| HI03-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI04-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis Code | |
| Component Element separator | 1 | : | |||||
| HI04-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI05-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis Code | |
| Component Element separator | 1 | : | |||||
| HI05-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI06-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis | |
| Component Element separator | 1 | : | |||||
| HI06-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI07-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis | |
| Component Element separator | 1 | : | |||||
| HI07-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI08-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis | |
| Component Element separator | 1 | : | |||||
| HI08-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI09-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis | |
| Component Element separator | 1 | : | |||||
| HI09-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI10-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis | |
| Component Element separator | 1 | : | |||||
| HI10-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI11-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis | |
| Component Element separator | 1 | : | |||||
| HI11-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Element Separator | AN | 1 | * | ||||
| HI12-1 | Code List Qualifier Code | ID | 1/3 | 1270 | R | BF = Diagnosis | |
| Component Element separator | 1 | : | |||||
| HI12-2 | Industry Code | AN | 1/30 | 1271 | R | Print Diagnosis code | |
| Segment Terminator | ~ | ||||||
| Field | Value |
| Claim No | 252 |
| Claim Location | NY Office |
| Place of Service | 11 - Office |
| Rendering Provider | David Mark |
| ICD Code | 410,415, 368.34, 522.3 |
Line items
| Procedure Code | Mod1 | Mod2 | Mod3 | Mod4 | ICD | FromDOS | ToDOS | Units | Unit Charges |
| 99214 | 1,2,3,4 | 01/09/2012 | 01/09/2012 | 1 | 40 | ||||
| 92570 | 1 | 01/09/2012 | 01/09/2012 | 1 | 180.04 | ||||
| 90371 | 3,4 | 01/09/2012 | 01/09/2012 | 1 | 83 |
HI*BK:410*BF:415*BF:36834*BF:5223~
By Loop
| 2300 - Claim Information | CLM | CLM*252*303.04***11:B:1*Y*A*Y*Y~ |
| 2300 - Claim Information - Clia Number | REF | REF*X4*CL324234~ |
| 2300 - Claim Information - ICDs | HI | HI*BK:410*BF:415*BF:36834*BF:5223~ |
| 2310B - Rendering Provider Name | NM1 | NM1*82*1*Mark*David****XX*1111111111~ |
| 2310D - Service Facility Location | NM1 | NM1*77*2*NY Office*****XX*1336177328~ |
| 2310D - Service Facility Location | N3 | N3*5081 Tellus. Avenue*668-2204 Non Rd.~ |
| 2310D - Service Facility Location | N4 | N4*White Plains*NY*809051232~ |
| 2310D - Service Facility Location | REF | REF*LU*484345~ |
| 2400 - Service Line | LX | LX*1~ |
| 2400 - Service Line | SV1 | SV1*HC:99214*40*UN*1*11**1:2:3:4~ |
| 2400 - Service Line | DTP | DTP*472*RD8*20120109-20120109~ |
| 2400 - Service Line | REF | REF*6R*1140~ |
| 2400 - Service Line | LX | LX*2~ |
| 2400 - Service Line | SV1 | SV1*HC:92570*180.04*UN*1*11**1~ |
| 2400 - Service Line | DTP | DTP*472*RD8*20120109-20120109~ |
| 2400 - Service Line | REF | REF*6R*1141~ |
| 2400 - Service Line | LX | LX*3~ |
| 2400 - Service Line | SV1 | SV1*HC:90371*83*UN*1*11**3:4~ |
| 2400 - Service Line | DTP | DTP*472*RD8*20120109-20120109~ |
| 2400 - Service Line | REF | REF*6R*1142~ |
ICD 10 Changes :
To convert ICD-9 to ICD-10 claim files, all the segments are remain same except the HI segement.
Example
ICD-9 claim HI segment with diagnosis code ( 0340 -shore throat) with Secondary diagnosis code -V202 for - child well visit.
HI*BK:0340*BF:V202~
After changing to ICD 10 :
HI*ABK:J020*ABF:Z00129~
To get ICD 10 Code by ICD 9, use the AMA online tool to convert