1364 Review Code

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

Type
Identifier (ID)
Length
Min 1 / Max 2
Codes
CodeDescription
ACase Turned Over to a Consultant
BPre-Admission Testing
CXray or Lab Procedure Related to a Covered Surgery
DProvider/Supplier determined the service is not covered, but the patient is requesting a formal review by the payor
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
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
LReserved for Local Assignment
NReserved for National Assignment

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