EDI 文档
X12 006040 Release
Transaction Set
Segments
Elements
Reference
/
X12 Release 006040
/
Elements
/
1351 Patient Signature Source Code
1351 Patient Signature Source Code
Code indicating how the patient or subscriber authorization signatures were obtained and how they are being retained by the provider
Type
ID
Length
Max 1 / Min 1
Codes
<> B
Signed signature authorization form or forms for both HCFA-1500 Claim Form block 12 and block 13 are on file
<> C
Signed HCFA-1500 Claim Form on file
<> M
Signed signature authorization form for HCFA-1500 Claim Form block 13 on file
<> P
Signature generated by provider because the patient was not physically present for services
<> S
Signed signature authorization form for HCFA-1500 Claim Form block 12 on file
