| Global Profile (Differential) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Seq# | Data Element | Description | Flags | Implement | Vocabulary | |||||
 IN3 | ||||||||||
  | 1 | 00502 | Set ID - IN3 | SHALL | ||||||
 | 29 | 02484 | Online Verification Result | C Condition defined for this element | MAY | repr: OnlineVerificationResult (CD) hl7VS-onlineVerificationResult (VS) onlineVerificationResult (CS) | ||||
| 30 | 02485 | Online Verification Result Error Code | C Condition defined for this element | MAY | repr: OnlineVerificationResultErrorCode (CD) hl7VS-onlineVerificationResultErrorCodes (VS) onlineVerificationResultErrorCodes (CS) | ||||
 | 31 | 02486 | Online Verification Result Check Digit | C Condition defined for this element | MAY | |||||
| Global Profile (Snapshot) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Seq# | Data Element | Description | Flags | Implement | Cardinality | Vocabulary | Data Type | |||
| IN3 | ||||||||||
| 1 | 00502 | Set ID - IN3 | SHALL | [1..1] | SI Sequence ID | ||||
| 2 | 00503 | Certification Number | MAY | [0..1] | CX Extended Composite ID with Check Digit | ||||
| 3 | 00504 | Certified By | MAY | [0..*] | XCN Extended Composite ID Number and Name for Persons | ||||
| 4 | 00505 | Certification Required | MAY | [0..1] | univ: Yes/noIndicator (CD) hl7VS-yes-no-Indicator (VS) expandedYes-NoIndicator (CS) | ID Coded Value for HL7 Defined Tables | |||
| 5 | 00506 | Penalty | MAY | [0..1] | MOP Money or Percentage | ||||
| 6 | 00507 | Certification Date/Time | MAY | [0..1] | DTM Date/Time | ||||
| 7 | 00508 | Certification Modify Date/Time | MAY | [0..1] | DTM Date/Time | ||||
| 8 | 00509 | Operator | MAY | [0..*] | XCN Extended Composite ID Number and Name for Persons | ||||
| 9 | 00510 | Certification Begin Date | MAY | [0..1] | DT Date | ||||
| 10 | 00511 | Certification End Date | MAY | [0..1] | DT Date | ||||
| 11 | 00512 | Days | MAY | [0..1] | DTN Day Type and Number | ||||
| 12 | 00513 | Non-Concur Code/Description | MAY | [0..1] | Non-concurCode_Description (CD) | CWE Coded with Exceptions | |||
| 13 | 00514 | Non-Concur Effective Date/Time | MAY | [0..1] | DTM Date/Time | ||||
| 14 | 00515 | Physician Reviewer | MAY | [0..*] | XCN Extended Composite ID Number and Name for Persons | ||||
| 15 | 00516 | Certification Contact | = Truncation allowed. | MAY | [0..1] | ST String Data | |||
| 16 | 00517 | Certification Contact Phone Number | MAY | [0..*] | XTN Extended Telecommunication Number | ||||
| 17 | 00518 | Appeal Reason | MAY | [0..1] | AppealReason (CD) | CWE Coded with Exceptions | |||
| 18 | 00519 | Certification Agency | MAY | [0..1] | CertificationAgency (CD) | CWE Coded with Exceptions | |||
| 19 | 00520 | Certification Agency Phone Number | MAY | [0..*] | XTN Extended Telecommunication Number | ||||
| 20 | 00521 | Pre-Certification Requirement | MAY | [0..*] | ICD Insurance Certification Definition | ||||
| 21 | 00522 | Case Manager | = Truncation allowed. | MAY | [0..1] | ST String Data | |||
| 22 | 00523 | Second Opinion Date | MAY | [0..1] | DT Date | ||||
| 23 | 00524 | Second Opinion Status | MAY | [0..1] | SecondOpinionStatus (CD) | CWE Coded with Exceptions | |||
| 24 | 00525 | Second Opinion Documentation Received | MAY | [0..*] | SecondOpinionDocumentationReceived (CD) | CWE Coded with Exceptions | |||
| 25 | 00526 | Second Opinion Physician | MAY | [0..*] | XCN Extended Composite ID Number and Name for Persons | ||||
| 26 | 03336 | Certification Type | MAY | [0..1] | ex.:CertificationTypeCode (CD) hl7VS-certificationTypeCode (VS) certificationType (CS) | CWE Coded with Exceptions | |||
| 27 | 03337 | Certification Category | MAY | [0..1] | ex.:CertificationCategoryCode (CD) hl7VS-certificationCategoryCode (VS) certificationCategory (CS) | CWE Coded with Exceptions | |||
| 28 | 02483 | Online Verification Date/Time | MAY | [0..1] | DTM Date/Time | ||||
| 29 | 02484 | Online Verification Result | C Condition defined for this element | MAY | T: [1..1]F: [0..0] | repr: OnlineVerificationResult (CD) hl7VS-onlineVerificationResult (VS) onlineVerificationResult (CS) | CWE Coded with Exceptions | ||
| 30 | 02485 | Online Verification Result Error Code | C Condition defined for this element | MAY | T: [0..1]F: [0..0] | repr: OnlineVerificationResultErrorCode (CD) hl7VS-onlineVerificationResultErrorCodes (VS) onlineVerificationResultErrorCodes (CS) | CWE Coded with Exceptions | ||
| 31 | 02486 | Online Verification Result Check Digit | C Condition defined for this element | MAY | T: [1..1]F: [0..0] | ST String Data | |||
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