01606
Reimbursement Action Code
2001-06-26
Definition: This field identifies the action to be taken during reimbursement calculations. If valued, this code overrides the value in GP2-6 - OCE edit code. Refer to Us er-defined Table 0459 - Reimbursement Action Code for suggested values. This field is defined by HCFA or other regulatory agencies
User-defined Table 0459 - Reimbursement Action Code
Length≤1
4 values
0 | OCE line item denial or rejection is not ignored |
1 | OCE line item denial or rejection is ignored |
2 | External line item denial. Line item is denied even if no OCE edits |
3 | External line item rejection. Line item is rejected even if no OCE edits |