HCR Health Care Services Review
HCR Health Care Services Review
To specify the outcome of a health care services review
Position
Element
Name
Type
Requirement
Min
Max
Repeat
HCR-01
Action Code
Identifier (ID)
Mandatory
1
2
-
Code indicating type of action.
HCR-02
Reference Number
String (AN)
Optional
1
30
-
Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.
HCR02 is the number assigned by the Information Source to this review outcome.
HCR-03
Reject Reason Code
Identifier (ID)
Optional
2
2
-
Code assigned by issuer to identify reason for rejection.
HCR-04
Yes/No Condition or Response Code
Identifier (ID)
Optional
1
1
-
Code indicating a Yes or No condition or response.
HCR04 is the Second Surgical Opinion indicator. A ``Y'' value indicates a Second Surgical Opinion is required, an ``N'' value indicates a Second Surgical Opinion is not required for this request.