UM Health Care Services Review Information
Opt
AtMax 1
To specify health care services review information
Elements
| 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 | |
Element Details
ID1525
NameRequest Category Code
LengthMin 1 / Max 2
Position1
RequirementMandatory
Codes
- <>RERecurring
- <>ARAdmission Review
- <>HSHealth Services Review
- <>INIndividual
- <>PRProgram Referral
- <>SCSpecialty Care Review
- <>BABatch