01606
Reimbursement Action Code
2015-07-13
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 User-defined Table 0459 - Reimbursement Action Code in Chapter 2C, Code Tables, for suggested values. This field is defined by CMS or other regulatory agencies
LengthNot specified
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 |
22 components
| 1 | O | - | Identifier | |
| 2 | O | - | Text | |
| 3 | C | Name of Coding System | ||
| 4 | O | - | Alternate Identifier | |
| 5 | O | - | Alternate Text | |
| 6 | C | Name of Alternate Coding System | ||
| 7 | C | - | Coding System Version ID | |
| 8 | O | - | Alternate Coding System Version ID | |
| 9 | O | - | Original Text | |
| 10 | O | - | Second Alternate Identifier | |
| 11 | O | - | Second Alternate Text | |
| 12 | C | Name of Second Alternate Coding System | ||
| 13 | O | - | Second Alternate Coding System Version ID | |
| 14 | C | - | Coding System OID | |
| 15 | O | - | Value Set OID | |
| 16 | C | - | Value Set Version ID | |
| 17 | C | - | Alternate Coding System OID | |
| 18 | O | - | Alternate Value Set OID | |
| 19 | C | - | Alternate Value Set Version ID | |
| 20 | C | - | Second Alternate Coding System OID | |
| 21 | O | - | Second Alternate Value Set OID | |
| 22 | C | - | Second Alternate Value Set Version ID |