1364Review Code

Batch

Code identifying extenuating circumstances or justifications which might assist any review of the medical necessity for this service

Element Details

Type ID

LengthMin 1 / Max 2

Codes

<>LReserved for Local Assignment
<>NReserved for National Assignment
<>ACase Turned Over to a Consultant
<>DProvider/Supplier determined the service is not covered, but the patient is requesting a formal review by the payor
<>BPre-Admission Testing
<>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
<>CX-ray or Lab Procedure Related to a Covered Surgery
<>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