FT1 - Financial Transaction Segment
The FT1 segment contains the detail data necessary to post charges, payments, adjustments, etc., to patient accounting records.
| SEQ | ELEMENT NAME |
|---|---|
| 1 | Set ID - FT1 |
| 2 | Transaction ID |
| 3 | Transaction Batch ID |
| 4 | Transaction Date |
| 5 | Transaction Posting Date |
| 6 | Transaction Type |
| 7 | Transaction Code |
| 8 | Transaction Description |
| 9 | Transaction Description - Alt |
| 10 | Transaction Quantity |
| 11 | Transaction Amount - Extended |
| 12 | Transaction Amount - Unit |
| 13 | Department Code |
| 14 | Health Plan ID |
| 15 | Insurance Amount |
| 16 | Assigned Patient Location |
| 17 | Fee Schedule |
| 18 | Patient Type |
| 19 | Diagnosis Code - FT1 |
| 20 | Performed By Code |
| 21 | Ordered By Code |
| 22 | Unit Cost |
| 23 | Filler Order Number |
| 24 | Entered By Code |
| 25 | Procedure Code |
| 26 | Procedure Code Modifier |
| 27 | Advanced Beneficiary Notice Code |
| 28 | Medically Necessary Duplicate Procedure Reason |
| 29 | NDC Code |
| 30 | Payment Reference ID |
| 31 | Transaction Reference Key |
| 32 | Performing Facility |
| 33 | Ordering Facility |
| 34 | Item Number |
| 35 | Model Number |
| 36 | Special Processing Code |
| 37 | Clinic Code |
| 38 | Referral Number |
| 39 | Authorization Number |
| 40 | Service Provider Taxonomy Code |
| 41 | Revenue Code |
| 42 | Prescription Number |
| 43 | NDC Qty and UOM |
| 44 |
FT1-1 Set ID - FT1 (SI) 00355
Definition: This field contains the number that identifies this transaction. For the first occurrence of the segment the sequence number shall be 1, for the second occurrence it shall be 2, etc.
FT1-2 Transaction ID (ST) 00356
Definition: This field contains a number assigned by the sending system for control purposes. The number can be returned by the receiving system to identify errors.
FT1-3 Transaction Batch ID (ST) 00357
Definition: This field uniquely identifies the batch in which this transaction belongs.
FT1-4 Transaction Date (DR) 00358
Components:
Definition: This field contains the date/time or date/time range of the transaction. For example, this field would be used to identify the date a procedure, item, or test was conducted or used. It may be defaulted to today's date. To specify a single point in time, only the first component is valued. When the second component is valued, the field specifies a time interval during which the transaction took place.
FT1-5 Transaction Posting Date (DTM) 00359
Definition: This field contains the date of the transaction that was sent to the financial system for posting.
FT1-6 Transaction Type (CWE) 00360
Components:
| Values | Description |
|---|---|
| CG | Charge |
| CD | Credit |
| PY | Payment |
| AJ | Adjustment |
| CO | Co-payment |
FT1-7 Transaction Code (CWE) 00361
Components: