08/28/2021
(ASC X12) 1364 Review Code
TYPE=ID MIN=1 MAX=2
Code identifying extenuating circumstances or justifications which might assist any review of the medical necessity for this service
Codes
| A | Case Turned Over to a Consultant |
| B | Pre-Admission Testing |
| C | X-ray or Lab Procedure Related to a Covered Surgery |
| D | Provider/Supplier determined the service is not covered, but the patient is requesting a formal review by the payor |
| E | Beneficiary 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 |
| F | Beneficiary 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 |
| L | Reserved for Local Assignment |
| N | Reserved for National Assignment |
Appears in
| SV1 | Professional Service |
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