SOAPware Documentation

Recent Updates

Updated on: Dec 07, 2022

CPT/HCPCS

Manual CMS 1500 New (02/12) Crosswalk

Loop 2400 Product/Service ID SV101 (2-6)
Updated on: Dec 07, 2022

EMG

Manual CMS 1500 New (02/12) Crosswalk

Emergency Indicator Loop 2400 SV109
Updated on: Dec 07, 2022

Place of Service

Manual CMS 1500 New (02/12) Crosswalk

CLM05-1 Facility Code Value Loop 2300 Place of Service Code SV105
Updated on: Dec 07, 2022

Dates of Service

Manual CMS 1500 New (02/12) Crosswalk

DTP03 Loop 2400
Updated on: Dec 07, 2022

Prior Authorization Number

Indicating the prior authorization number.

Manual CMS 1500 New (02/12) Crosswalk

Loop 2300 Prior Authorization Number REF02
Updated on: Dec 07, 2022

Resubmission Code and Original Reference Number

Indicating Claim Frequency Code, Payer Claim Control Number

Manual CMS 1500 New (02/12) Crosswalk

Claim Frequency Code CLM05-3 Loop 2300 Payer Claim Control Number REF02
Updated on: Dec 07, 2022

Diagnosis Codes

Diagnosis codes populate the CMS 1500 form in order of the diagnosis codes listed, and display by charge. Loop 2300, Segment/Data Element HI01-2 through HI12-2

Manual CMS 1500 New (02/12) Crosswalk

HI01-2 HI02-2 HI03-2 HI04-2 HI05-2 HI06-2 HI07-2 HI08-2 HI09-2 HI10-2 HI11-2 HI12-2 Loop 2300
Updated on: Dec 07, 2022

Outside Lab

Indicating outside lab and any associated charges

Manual CMS 1500 New (02/12) Crosswalk

Loop 2400 PS102 Purchased Service Charge Amount
Updated on: Dec 07, 2022

Reserved for Local Use

Enter free text for miscellaneous information needed in box 19 on the CMS 1500 form.

Manual CMS 1500 New (02/12) Crosswalk

Block 19 Box 19 CMS 1500 Reserved for Local Use
Updated on: Dec 07, 2022

Hospitalization Dates

Indicating hospitalization dates.

Manual CMS 1500 New (02/12) Crosswalk

DTP03 Loop 2300 Related Discharge Date Related Hospitalization Admission Date