Element
X12 EDI Release 00501
SV1
1364Review Code
Code identifying extenuating circumstances or justifications which might assist any review of the medical necessity for this service
属性
数据类型ID
必须?Optional
Codes (8)
  • ACase Turned Over to a Consultant
  • BPre-Admission Testing
  • CX-ray or Lab Procedure Related to a Covered Surgery
  • DProvider/Supplier determined the service is not covered, but the patient is requesting a formal review by the payor
  • EBeneficiary was notified that the item might not be considered medically necessary and has agreed in writing to pay for the item; A signed waiver is on file with the provider
  • FBeneficiary was notified that the item might not be considered medically necessary and has not agreed to pay for the item; No signed waiver is on file with the provider
  • LReserved for Local Assignment
  • NReserved for National Assignment