01310

Advanced Beneficiary Notice Code

2007-10-26
Definition: This field indicates the status of the patient's or the patient's representative's consent for responsibility to pay for potentially uninsured services. This element is introduced to satisfy CMS Medical Necessity requirements for outpatient services. This element indicates (a) whether the associated diagnosis codes for the service are subject to medical necessity procedures, (b) whether, for this type of service, the patient has been informed that they may be responsible for payment for the service, and (c) whether the patient agrees to be billed for this service. The values for this field are drawn from User-Defined Table 0339 - Advanced Beneficiary Notice Code.
Length≤250
4 values
1Service is subject to medical necessity procedures
2Patient has been informed of responsibility, and agrees to pay for service
3Patient has been informed of responsibility, and asks that the payer be billed
4Advanced Beneficiary Notice has not been signed
9 components
1O-Identifier
2O-Text
3OName of Coding System
4O-Alternate Identifier
5O-Alternate Text
6OName of Alternate Coding System
7C-Coding System Version ID
8O-Alternate Coding System Version ID
9O-Original Text