To specify health care services review information
Position | Element | Name | Type | Min/Max | Repeat | ||
---|---|---|---|---|---|---|---|
1 | 1525 | Request Category Code | Mandatory | ID | 1/2 | AtMax 1 | |
2 | 1322 | Certification Type Code | Opt | ID | 1/1 | AtMax 1 | |
3 | 1365 | Service Type Code | Opt | ID | 1/2 | AtMax 1 | |
AtMax 1 | |||||||
AtMax 1 | |||||||
6 | 1338 | Level of Service Code | Opt | ID | 1/3 | AtMax 1 | |
7 | 1213 | Current Health Condition Code | Opt | ID | 1/1 | AtMax 1 | |
8 | 923 | Prognosis Code | Opt | ID | 1/1 | AtMax 1 | |
9 | 1363 | Release of Information Code | Opt | ID | 1/1 | AtMax 1 | |
10 | 1514 | Delay Reason Code | Opt | ID | 1/2 | AtMax 1 |