EDI 270 Segments and Elements for the Eligibility, Coverage Or Benefit Inquiry Standard

AgencySet IDFGTransaction DescriptionSubcommittee
ANSI270HSEligibility, Coverage Or Benefit Inquiry Insurance

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See the list of EDI 270 segments and elements in below data grid. The Jobisez.com site has an online translation tool that converts the EDI 270 (Eligibility, Coverage Or Benefit Inquiry) document into a CSV file. For more detailed information, you can view a sample EDI 270 document by analyzing a transaction set example. If you are researching the 270s, you can view other trading partner's mapping specifications. You can also gain knowledge by researching all EDI document types. Jobisez LLC can also provide assistance if you need additional help.

The EDI 270 Segments and Elements

SegmentDescriptionSectReqMax LoopMax UsagePos
BHTBeginning Of Hierarchical TransactionHM011
HLHierarchical LevelDM99999912
NM1Individual Or Organizational NameDM99999914
REFReference InformationDO095
N2Additional Name InformationDO016
N3Party LocationDO017
N4Geographic LocationDO018
PERAdministrative Communications ContactDO039
PRVProvider InformationDO0110
DMGDemographic InformationDO0111
INSInsured BenefitDO0112
HIHealth Care Information CodesDO0113
DTPDate Or Time Or PeriodDO0914
MPIMilitary Personnel InformationDO0915
EQEligibility Or Benefit InquiryDO99116
AMTMonetary Amount InformationDO0217
VEHVehicle InformationDO0118
PDRProperty Description - RealDO0119
PDPProperty Description - PersonalDO0120
REFReference InformationDO0122
DTPDate Or Time Or PeriodDO0923

SegmentElementDescriptionReqMin LengthMax LengthType
BHT1Hierarchical Structure CodeM44ID
BHT2Transaction Set Purpose CodeM22ID
BHT3Reference IdentificationO150AN
BHT6Transaction Type CodeO22ID
HL1Hierarchical Id NumberM112AN
HL2Hierarchical Parent Id NumberO112AN
HL3Hierarchical Level CodeM12ID
HL4Hierarchical Child CodeO11ID
TRN1Trace Type CodeM12ID
TRN2Reference IdentificationM150AN
TRN3Originating Company IdentifierO1010AN
TRN4Reference IdentificationO150AN
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
PER1Contact Function CodeM22ID
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
PRV1Provider CodeM13ID
PRV2Reference Identification QualifierC23ID
PRV3Reference IdentificationC150AN
PRV4State Or Province CodeO22ID
PRV5Provider Specialty CodeO13AN
PRV6Agency Qualifier CodeO22ID
PRV7Yes/No Condition Or Response CodeO11ID
PRV8Provider Organization CodeO33ID
DMG1Date Time Period Format QualifierC23ID
DMG2Date Time PeriodC135AN
DMG3Gender CodeO11ID
DMG4Marital Status CodeO11ID
DMG5Race Or Ethnicity CodeC11ID
DMG6Code List Qualifier CodeC13ID
DMG7Industry CodeC130AN
DMG8Citizenship Status CodeO12ID
DMG9Country CodeO23ID
DMG10Basis Of Verification CodeO12ID
DMG12Code List Qualifier CodeC13ID
DMG13Industry CodeC130AN
INS1Yes/No Condition Or Response CodeM11ID
INS2Individual Relationship CodeM22ID
INS3Maintenance Type CodeO33ID
INS4Maintenance Reason CodeO23ID
INS5Benefit Status CodeO11ID
INS6Medicare Plan CodeO11ID
INS7Eligibility Reason CodeO11ID
INS8Eligibility Reason CodeO11ID
INS9Eligibility Reason CodeO11ID
INS10Consolidated Omnibus Budget Reconciliation Act (Cobra) QualifyingO12ID
INS11Employment Status CodeO22ID
INS12Student Status CodeO11ID
INS13Yes/No Condition Or Response CodeO11ID
INS14Date Time Period Format QualifierC23ID
INS15Date Time PeriodC135AN
INS16Confidentiality CodeO11ID
INS17City NameO230AN
INS18State Or Province CodeO22ID
INS19Country CodeO23ID
HI1Code List Qualifier CodeM13ID
HI2Industry CodeM130AN
HI3Date Time Period Format QualifierM23ID
HI4Date Time PeriodM135AN
HI5Monetary AmountM118R
HI7Version IdentifierM130AN
HI8Industry CodeM130AN
HI9Yes/No Condition Or Response CodeM11ID
HI10Code List Qualifier CodeO13ID
HI11Industry CodeO130AN
HI12Date Time Period Format QualifierO23ID
HI13Date Time PeriodO135AN
HI14Monetary AmountO118R
HI16Version IdentifierO130AN
HI17Industry CodeO130AN
HI18Yes/No Condition Or Response CodeO11ID
HI19Code List Qualifier CodeO13ID
HI20Industry CodeO130AN
HI21Date Time Period Format QualifierO23ID
HI22Date Time PeriodO135AN
HI23Monetary AmountO118R
HI25Version IdentifierO130AN
HI26Industry CodeO130AN
HI27Yes/No Condition Or Response CodeO11ID
HI28Code List Qualifier CodeO13ID
HI29Industry CodeO130AN
HI30Date Time Period Format QualifierO23ID
HI31Date Time PeriodO135AN
HI32Monetary AmountO118R
HI34Version IdentifierO130AN
HI35Industry CodeO130AN
HI36Yes/No Condition Or Response CodeO11ID
HI37Code List Qualifier CodeO13ID
HI38Industry CodeO130AN
HI39Date Time Period Format QualifierO23ID
HI40Date Time PeriodO135AN
HI41Monetary AmountO118R
HI43Version IdentifierO130AN
HI44Industry CodeO130AN
HI45Yes/No Condition Or Response CodeO11ID
HI46Code List Qualifier CodeO13ID
HI47Industry CodeO130AN
HI48Date Time Period Format QualifierO23ID
HI49Date Time PeriodO135AN
HI50Monetary AmountO118R
HI52Version IdentifierO130AN
HI53Industry CodeO130AN
HI54Yes/No Condition Or Response CodeO11ID
HI55Code List Qualifier CodeO13ID
HI56Industry CodeO130AN
HI57Date Time Period Format QualifierO23ID
HI58Date Time PeriodO135AN
HI59Monetary AmountO118R
HI61Version IdentifierO130AN
HI62Industry CodeO130AN
HI63Yes/No Condition Or Response CodeO11ID
HI64Code List Qualifier CodeO13ID
HI65Industry CodeO130AN
HI66Date Time Period Format QualifierO23ID
HI67Date Time PeriodO135AN
HI68Monetary AmountO118R
HI70Version IdentifierO130AN
HI71Industry CodeO130AN
HI72Yes/No Condition Or Response CodeO11ID
HI73Code List Qualifier CodeO13ID
HI74Industry CodeO130AN
HI75Date Time Period Format QualifierO23ID
HI76Date Time PeriodO135AN
HI77Monetary AmountO118R
HI79Version IdentifierO130AN
HI80Industry CodeO130AN
HI81Yes/No Condition Or Response CodeO11ID
HI82Code List Qualifier CodeO13ID
HI83Industry CodeO130AN
HI84Date Time Period Format QualifierO23ID
HI85Date Time PeriodO135AN
HI86Monetary AmountO118R
HI88Version IdentifierO130AN
HI89Industry CodeO130AN
HI90Yes/No Condition Or Response CodeO11ID
HI91Code List Qualifier CodeO13ID
HI92Industry CodeO130AN
HI93Date Time Period Format QualifierO23ID
HI94Date Time PeriodO135AN
HI95Monetary AmountO118R
HI97Version IdentifierO130AN
HI98Industry CodeO130AN
HI99Yes/No Condition Or Response CodeO11ID
HI100Code List Qualifier CodeO13ID
HI101Industry CodeO130AN
HI102Date Time Period Format QualifierO23ID
HI103Date Time PeriodO135AN
HI104Monetary AmountO118R
HI106Version IdentifierO130AN
HI107Industry CodeO130AN
HI108Yes/No Condition Or Response CodeO11ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
MPI1Information Status CodeM11ID
MPI2Employment Status CodeM22ID
MPI3Government Service Affiliation CodeM11ID
MPI5Military Service Rank CodeO22ID
MPI6Date Time Period Format QualifierC23ID
MPI7Date Time PeriodC135AN
EQ1Service Type CodeC12ID
EQ2Product/Service Id QualifierC22ID
EQ3Product/Service IdC148AN
EQ4Procedure ModifierC22AN
EQ5Procedure ModifierC22AN
EQ6Procedure ModifierC22AN
EQ7Procedure ModifierC22AN
EQ9Product/Service IdC148AN
EQ10Coverage Level CodeO33ID
EQ11Insurance Type CodeO13ID
EQ12Diagnosis Code PointerO12N0
EQ13Diagnosis Code PointerO12N0
EQ14Diagnosis Code PointerO12N0
EQ15Diagnosis Code PointerO12N0
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
VEH1Assigned NumberO16N0
VEH2Vehicle Identification NumberO130AN
VEH4Agency Qualifier CodeC22ID
VEH5Reference IdentificationC150AN
VEH6Reference IdentificationO150AN
VEH7Reference IdentificationC150AN
VEH9Reference IdentificationO150AN
VEH10State Or Province CodeO22ID
VEH11Location IdentifierO130AN
VEH12Yes/No Condition Or Response CodeO11ID
VEH14Yes/No Condition Or Response CodeO11ID
VEH16Action CodeO12ID
VEH17Country CodeO23ID
VEH19Country CodeC23ID
PDR1Type Of Real Estate Asset CodeM22ID
PDR2Code List Qualifier CodeC13ID
PDR3Industry CodeC130AN
PDR4Occupancy CodeO22ID
PDP1Type Of Personal Or Business Asset CodeM22ID
PDP2Commodity Code QualifierC11ID
PDP3Commodity CodeC130AN
III1Code List Qualifier CodeC13ID
III2Industry CodeC130AN
III3Code CategoryO22ID
III4Free-Form Message TextC1264AN
III6Unit Or Basis For Measurement CodeO22ID
III9Unit Or Basis For Measurement CodeO22ID
III12Unit Or Basis For Measurement CodeO22ID
III15Unit Or Basis For Measurement CodeO22ID
III18Unit Or Basis For Measurement CodeO22ID
III21Surface/Layer/Position CodeO22ID
III22Surface/Layer/Position CodeO22ID
III23Surface/Layer/Position CodeO22ID
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN

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