API ReferenceService LinesV2

Create Professional or Institutional Service Line

Beta

Headers

AuthorizationstringRequired

OAuth authentication of the form <token>.

Request

This endpoint expects an object.
claim_idUUIDRequired
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
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.

procedure_codestringOptional
revenue_codestringOptional

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).

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 or null
charge_amount_centsinteger or null
allowed_amount_centsinteger or null
insurance_balance_centsinteger or null
patient_balance_centsinteger or null
paid_amount_centsinteger or null
primary_paid_amount_centsinteger or null
secondary_paid_amount_centsinteger or null
tertiary_paid_amount_centsinteger or null
patient_responsibility_centsinteger or null
copay_centsinteger or null
coinsurance_centsinteger or null
deductible_centsinteger or null
diagnosis_id_zeroUUID or null
diagnosis_id_oneUUID or null
diagnosis_id_twoUUID or null
diagnosis_id_threeUUID or null
drug_identificationobject or null
service_line_era_dataobject or null
service_line_manual_adjustmentslist of objects or null
related_invoiceslist of objects or null
related_invoice_infolist of objects or null
denial_reasonobject or null
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 or null

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.

place_of_service_code_as_submittedenum or null

837p Loop2300, SV105. 02 for telemedicine, 11 for in-person. Full list here.

ordering_providerobject or null
revenue_codestring or null

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 or null

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 or null
test_resultslist of objects or null

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 or null

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 or null

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 or null
Maps to NTE02 loop 2400 on the EDI 837.

Errors