VERSION 004010X098A1 - Magellan Provider's Home Page

Magellan Behavioral Health 837 Professional Companion GuideHIHealth Care Diagnosis CodePos: 231 Max: 1Detail - OptionalLoop: 2300 Elements: 4Magellan Specific Note: Magellan will only use the first 4 diagnosis codes for processing.Element Summary:Ref Id Element Name Req Type Min/Max UsageHI01 C022 Health Care Code InformationM Comp RequiredDescription: To send health care codes and theirassociated dates, amounts and quantitiesWith a few exceptions, it is not recommended toput E codes in HI01. E codes may be put in anyother HI element using BF as the qualifier.The diagnosis listed in this element is assumedto be the principal diagnosis.HI01 – 1 1270 Code List Qualifier CodeM ID 1/3 RequiredDescription: Code identifying a specific industrycode listBK - Principal DiagnosisHI01 – 2 1271 Industry CodeDescription: Code indicating a code from a specificindustry code listHI02 C022 Health Care Code InformationDescription: To send health care codes and theirassociated dates, amounts and quantitiesHI02 – 1 1270 Code List Qualifier CodeM AN 1/30 RequiredO Comp SituationalM ID 1/3 RequiredDescription: Code identifying a specific industrycode listBF - DiagnosisHI02 – 2 1271 Industry CodeM AN 1/30 RequiredDescription: Code indicating a code from a specificindustry code listHI03 C022 Health Care Code InformationDescription: To send health care codes and theirassociated dates, amounts and quantitiesHI03 – 1 1270 Code List Qualifier CodeO Comp SituationalM ID 1/3 RequiredDescription: Code identifying a specific industrycode listBF - DiagnosisHI03 – 2 1271 Industry CodeM AN 1/30 RequiredDescription: Code indicating a code from a specificindustry code list_________________________________________________________________________________________________________________________Revised: February 14, 2008 HIPAA X12 837p (004010X098A1) Version 7 22