EDI Dictionary
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X12 Release 4010
X12 Release
4010
4020
4030
4040
4050
4060
5010
5020
5030
5040
5050
6010
6020
6030
6040
6050
7010
7020
7030
7040
7050
7060
8010
Transaction Sets
Segments
Elements
EDI-Dictionary
4010
UM
UM
Health Care Services Review Information
Batch
To specify health care services review information
Elements
Position
Element
Name
Type
Min/Max
Repeat
1
1525
Request Category Code
Mandatory
ID
1/2
1
2
1322
Certification Type Code
Opt
ID
1/1
1
3
1365
Service Type Code
Opt
ID
1/2
1
C023
Health Care Service Location Information
Opt
1
C024
Related Causes Information
Opt
1
6
1338
Level of Service Code
Opt
ID
1/3
1
7
1213
Current Health Condition Code
Opt
ID
1/1
1
8
923
Prognosis Code
Opt
ID
1/1
1
9
1363
Release of Information Code
Opt
ID
1/1
1
10
1514
Delay Reason Code
Opt
ID
1/2
1
Element Details
ID
1525
Name
Request Category Code
Length
Min 1 / Max 2
Position
1
Requirement
Mandatory
Codes
<>
RE
Recurring
<>
AR
Admission Review
<>
HS
Health Services Review
<>
IN
Individual
<>
PR
Program Referral
<>
SC
Specialty Care Review
<>
BA
Batch