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
1 | Service is subject to medical necessity procedures |
2 | Patient has been informed of responsibility, and agrees to pay for service |
3 | Patient has been informed of responsibility, and asks that the payer be billed |
4 | Advanced Beneficiary Notice has not been signed |
9 components
| 1 | O | - | Identifier | |
| 2 | O | - | Text | |
| 3 | O | Name of Coding System | ||
| 4 | O | - | Alternate Identifier | |
| 5 | O | - | Alternate Text | |
| 6 | O | Name of Alternate Coding System | ||
| 7 | C | - | Coding System Version ID | |
| 8 | O | - | Alternate Coding System Version ID | |
| 9 | O | - | Original Text |