IN3 - Insurance additional information, certification segment (HL7 v2.3.1)
Versions: v2.3 v2.3.1 v2.4 v2.5.1 v2.6 v2.7.1
The IN3 segment (Insurance additional information, certification segment) has 25 fields in HL7 v2.3.1. Fields are addressed as
IN3-n; composite fields break into components IN3-n.m. Paste a message into the
parser to see every field annotated with this table.
| # | Name | Type | Len | Opt | Repeats | Table |
|---|---|---|---|---|---|---|
| 1 | Set ID - IN3 | SI | 4 | Required | No | |
| 2 | Certification Number | CX | 59 | Optional | No | |
| 3 | Certified By | XCN | 60 | Optional | Yes | |
| 4 | Certification Required | ID | 1 | Optional | No | 0136 |
| 5 | Penalty | MOP | 10 | Optional | No | |
| 6 | Certification Date/Time | TS | 26 | Optional | No | |
| 7 | Certification Modify Date/Time | TS | 26 | Optional | No | |
| 8 | Operator | XCN | 60 | Optional | Yes | |
| 9 | Certification Begin Date | DT | 8 | Optional | No | |
| 10 | Certification End Date | DT | 8 | Optional | No | |
| 11 | Days | DTN | 3 | Optional | No | |
| 12 | Non-Concur Code/Description | CE | 60 | Optional | No | |
| 13 | Non-Concur Effective Date/Time | TS | 26 | Optional | No | |
| 14 | Physician Reviewer | XCN | 60 | Optional | Yes | |
| 15 | Certification Contact | ST | 48 | Optional | No | |
| 16 | Certification Contact Phone Number | XTN | 40 | Optional | Yes | |
| 17 | Appeal Reason | CE | 60 | Optional | No | |
| 18 | Certification Agency | CE | 60 | Optional | No | |
| 19 | Certification Agency Phone Number | XTN | 40 | Optional | Yes | |
| 20 | Pre-Certification Req/Window | PCF | 40 | Optional | Yes | |
| 21 | Case Manager | ST | 48 | Optional | No | |
| 22 | Second Opinion Date | DT | 8 | Optional | No | |
| 23 | Second Opinion Status | IS | 1 | Optional | No | 0151 |
| 24 | Second Opinion Documentation Received | IS | 1 | Optional | Yes | 0152 |
| 25 | Second Opinion Physician | XCN | 60 | Optional | Yes |