RF1
Referral Information
Attention: Retained for backwards compatibility as of V2.9. Refer to 7.4.4 for the PRT segment instead.
This segment represents information that may be useful when sending referrals from the referring provider to the referred-to provider.
RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler
25
| C.Len | Element | v2.8.2 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | - | - | CWE | O | 1 | 0283 | 01137 | RF1-1 | Referral Status | |
| 2 | - | - | CWE | O | 1 | 0280 | 01138 | RF1-2 | Referral Priority | |
| 3 | - | - | CWE | O | 1 | 0281 | 01139 | RF1-3 | Referral Type | |
| 4 | - | - | CWE | O | * | 0282 | 01140 | RF1-4 | Referral Disposition | |
| 5 | - | - | CWE | O | 1 | 0284 | 01141 | RF1-5 | Referral Category | |
| 6 | - | - | EI | R | 1 | - | 01142 | RF1-6 | Originating Referral Identifier | |
| 7 | - | - | DTM | O | 1 | - | 01143 | RF1-7 | Effective Date | |
| 8 | - | - | DTM | O | 1 | - | 01144 | RF1-8 | Expiration Date | |
| 9 | - | - | DTM | O | 1 | - | 01145 | RF1-9 | Process Date | |
| 10 | - | - | CWE | O | * | 0336 | 01228 | RF1-10 | Referral Reason | |
| 11 | - | - | EI | O | * | - | 01300 | RF1-11 | External Referral Identifier | |
| 12 | - | - | CWE | O | 1 | 0865 | 02262 | RF1-12 | Referral Documentation Completion Status | |
| 13 | ..24 | - | DTM | O | 1 | - | 03400 | RF1-13 | Planned Treatment Stop Date | |
| 14 | ..60 | - | ST | O | 1 | - | 03401 | RF1-14 | Referral Reason Text | Length |
| 15 | ..721 | - | CQ | O | 1 | - | 03402 | RF1-15 | Number of Authorized Treatments/Units | |
| 16 | ..721 | - | CQ | O | 1 | - | 03403 | RF1-16 | Number of Used Treatments/Units | |
| 17 | ..721 | - | CQ | O | 1 | - | 03404 | RF1-17 | Number of Schedule Treatments/Units | |
| 18 | ..20 | - | MO | O | 1 | - | 03405 | RF1-18 | Remaining Benefit Amount | |
| 19 | ..250 | - | XON | O | 1 | - | 03406 | RF1-19 | Authorized Provider | Length |
| 20 | ..250 | - | XCN | O | 1 | - | 03407 | RF1-20 | Authorized Health Professional | Length |
| 21 | ..60 | - | ST | O | 1 | - | 03408 | RF1-21 | Source Text | Length |
| 22 | ..24 | - | DTM | O | 1 | - | 03409 | RF1-22 | Source Date | |
| 23 | ..250 | - | XTN | O | 1 | - | 03410 | RF1-23 | Source Phone | Length |
| 24 | ..250 | - | ST | O | 1 | - | 03411 | RF1-24 | Comment | Length |
| 25 | ..1 | - | ID | O | 1 | 0206 | 03412 | RF1-25 | Action Code |
14