Implementation

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To understand how these Type 6 rules are processed in hipaa_data_compliance, consider the following three aspects of Type 6 rules:

What the line of service is – e.g. ambulance.
What segment/element in the transaction determines whether the claim involves this line of service.

The first is the rule that is present in the hipaa_x12_qualifier.json rules file.

The second aspect is encoded as a category within the code set name in the hipaa_x12_qualifier.json file, such as AMB for an ambulance in the code table ID field "CodeTableID" : "T6_ST_MRT_AMB".

The final aspect is also encoded as a service location, in the code table id, such as “ST” in "CodeTableID" : "T6_ST_MRT_AMB".

Table 1. Type 6 Service Categories
Category code	Description
ANE	Anesthesia
CHR	Chiropractic (spinal manipulation)
DEN	Dental
DME	Durable Medical Equipment
HHC	Home Health Care Services
HPC	Hospice
MBH	Mental and Behavioral Health
MRT	Medically Related Transportation
OXY	Oxygen Therapy
PEN	Parenteral / Enteral Nutrition
POD	Podiatry
RXD	Prescription Drug
SUG	Surgery
VIS	Vision (optometry)

Table 2. Type 6 Service Locations
Transaction Set	Source Type Code ST	Product or Service Identification PS	Form Identification code FC
278	2000E UM03 2000F UM03	2000F SV101-01 + SV101-02 2000F SV202-01 + SV202-02 2000F SV301-01 + SV301-02
837		2400 SV101-01 + SV101-02 2400 SV202-01 + SV202-02 2400 SV301-01 + SV301-02	2440 LQ01+02