API ReferenceService LinesV2

Create Service Line

Beta

Authentication

AuthorizationBearer

OAuth authentication of the form <token>.

Request

This endpoint expects an object.
claim_idUUIDRequired
procedure_codestringRequired
quantitystringRequired

String representation of a Decimal that can be parsed by most libraries. For professional claims, a ServiceLine quantity cannot contain more than one digit of precision (Example: 1.1 is valid, 1.11 is not). For institutional claims, a ServiceLine quantity cannot contain more than three decimal digits of precision.

unitsenumRequired
Allowed values:
charge_amount_centsintegerOptional
The total amount charged for this service line, factoring in quantity. The system will attempt to set it based on the chargemaster configuration and the service line’s quantity. For example, if a single unit has an entry of 100 cents and 2 units were rendered, the charge_amount_cents will be set to 200. If there is no chargemaster entry, the system will default to the amount set via this field.
date_of_servicedateOptional
denial_reasonobjectOptional
The reason a given service line was denied within a given time range. A service line may be denied for different reasons over time, but only one reason at a time.
descriptionstringOptional

A free-form description to clarify the related data elements and their content. Maps to SV1-01, C003-07 on a 837-P and SV2-02, C003-07 on a 837-I form.

diagnosis_id_oneUUIDOptional
diagnosis_id_threeUUIDOptional
diagnosis_id_twoUUIDOptional
diagnosis_id_zeroUUIDOptional
drug_identificationobjectOptional
end_date_of_servicedateOptional
external_idstringOptional
An external identifier for this service line. This is not used in the EDI 837, but can be used to identify the service line in external systems. This field should not contain PHI. Must be unique on a given claim.
has_epsdt_indicatorbooleanOptional

Maps to SV1-11 on the 837-P and Box 24H on the CMS-1500. If the value is true, the box will be populated with “Y”. Otherwise, the box will not be populated.

has_family_planning_indicatorbooleanOptional

Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500. If the value is true, the box will be populated with “Y”. Otherwise, the box will not be populated.

modifierslist of enumsOptional
notestringOptional
Maps to NTE02 loop 2400 on the EDI 837.
ordering_providerobjectOptional
Required when the service or supply was ordered by a provider who is different than the rendering provider for this service line. If not required by this implementation guide, do not send.
place_of_service_codeenumOptional
837p Loop2300, SV105. This enum is not used or required in 837i claims. If your organization does not intend to submit claims with a different place of service at the service line level, this field should not be populated. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
prior_authorization_numberstringOptional

Prior authorization number for this service line. Maps to the appropriate REF segment on Loop 2400 of the EDI 837p. This is not used for institutional claims (EDI 837i).

test_resultslist of objectsOptional

Contains a list of test results. Test result types may map to MEA-02 on the 837-P (ex: Hemoglobin, Hematocrit). This is unused by 837-i and ignored for institutional service lines. No more than 5 MEA-02 test results may be submitted per service line.

Response

This endpoint returns an object.
created_atdatetime
service_line_idUUID
procedure_codestring
quantitystring

String representation of a Decimal that can be parsed by most libraries. For professional claims, a ServiceLine quantity cannot contain more than one digit of precision (Example: 1.1 is valid, 1.11 is not). For institutional claims, a ServiceLine quantity cannot contain more than three decimal digits of precision.

unitsenum
Allowed values:
claim_idUUID
date_of_service_rangeobject
A range of dates of service for this service line. If the service line is for a single date, the end date will be empty.
date_of_servicedate
modifierslist of enums
charge_amount_centsinteger
allowed_amount_centsinteger
insurance_balance_centsinteger
patient_balance_centsinteger
paid_amount_centsinteger
primary_paid_amount_centsinteger
secondary_paid_amount_centsinteger
tertiary_paid_amount_centsinteger
patient_responsibility_centsinteger
copay_centsinteger
coinsurance_centsinteger
deductible_centsinteger
diagnosis_id_zeroUUID
diagnosis_id_oneUUID
diagnosis_id_twoUUID
diagnosis_id_threeUUID
drug_identificationobject
service_line_era_dataobject
service_line_manual_adjustmentslist of objects
related_invoiceslist of objects
related_invoice_infolist of objects
denial_reasonobject
The reason a given service line was denied within a given time range. A service line may be denied for different reasons over time, but only one reason at a time.
place_of_service_codeenum
837p Loop2300, SV105. This enum is not used or required in 837i claims. If your organization does not intend to submit claims with a different place of service at the service line level, this field should not be populated. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
place_of_service_code_as_submittedenum
837p Loop2300, SV105. 02 for telemedicine, 11 for in-person. Full list [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set).
ordering_providerobject
revenue_codestring

A 4 digit code that specifies facility department or type of service arrangement for institutional service line items (837i). This code is not required for professional claim billing (837p).

descriptionstring

A free-form description to clarify the related data elements and their content. Maps to SV1-01, C003-07 on a 837-P and SV2-02, C003-07 on a 837-I form.

end_date_of_servicedate
test_resultslist of objects

Contains a list of test results. Test result types may map to MEA-02 on the 837-P (ex: Hemoglobin, Hematocrit). This is unused by 837-i and ignored for institutional service lines. No more than 5 MEA-02 test results may be submitted per service line.

has_epsdt_indicatorboolean

Maps to SV1-11 on the 837-P and Box 24H on the CMS-1500. If the value is true, the box will be populated with “Y”. Otherwise, the box will not be populated.

has_family_planning_indicatorboolean

Maps to SV1-12 on the 837-P and Box 24I on the CMS-1500. If the value is true, the box will be populated with “Y”. Otherwise, the box will not be populated.

notestring
Maps to NTE02 loop 2400 on the EDI 837.
prior_authorization_numberstring

Prior authorization number for this service line. Maps to the appropriate REF segment on Loop 2400 of the EDI 837p. This is not used for institutional claims (EDI 837i).

external_idstring
An external identifier for this service line. This is not used in the EDI 837, but can be used to identify the service line in external systems. This field should not contain PHI. Must be unique on a given claim.

Errors

409
Entity Conflict Error
422
HTTP Request Validation Error