IN3 - Insurance Additional Information, Certification (HL7 v2.7.1)
Versions: v2.3 v2.3.1 v2.4 v2.5.1 v2.6 v2.7.1
The IN3 segment (Insurance Additional Information, Certification) has 25 fields in HL7 v2.7.1. 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 | Optional | No | ||
| 3 | Certified By | XCN | Optional | Yes | ||
| 4 | Certification Required | ID | 1 | Optional | No | 0136 |
| 5 | Penalty | MOP | Optional | No | ||
| 6 | Certification Date/Time | DTM | Optional | No | ||
| 7 | Certification Modify Date/Time | DTM | Optional | No | ||
| 8 | Operator | XCN | Optional | Yes | ||
| 9 | Certification Begin Date | DT | Optional | No | ||
| 10 | Certification End Date | DT | Optional | No | ||
| 11 | Days | DTN | Optional | No | ||
| 12 | Non-Concur Code/Description | CWE | Optional | No | 0233 | |
| 13 | Non-Concur Effective Date/Time | DTM | Optional | No | ||
| 14 | Physician Reviewer | XCN | Optional | Yes | 0010 | |
| 15 | Certification Contact | ST | Optional | No | ||
| 16 | Certification Contact Phone Number | XTN | Optional | Yes | ||
| 17 | Appeal Reason | CWE | Optional | No | 0345 | |
| 18 | Certification Agency | CWE | Optional | No | 0346 | |
| 19 | Certification Agency Phone Number | XTN | Optional | Yes | ||
| 20 | Pre-Certification Requirement | ICD | Optional | Yes | ||
| 21 | Case Manager | ST | Optional | No | ||
| 22 | Second Opinion Date | DT | Optional | No | ||
| 23 | Second Opinion Status | CWE | Optional | No | 0151 | |
| 24 | Second Opinion Documentation Received | CWE | Optional | Yes | 0152 | |
| 25 | Second Opinion Physician | XCN | Optional | Yes | 0010 |