HCR Health Care Services Review

To specify the outcome of a health care services review

Position: HCR-01 · Element: 306 · Name: Action Code · Type: Identifier (ID) · Requirement: Mandatory · Min: 1 · Max: 2 · Repeat: -

Code indicating type of action.

Position: HCR-02 · Element: 127 · Name: Reference Number · Type: String (AN) · Requirement: Optional · Min: 1 · Max: 30 · Repeat: -

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.

Position: HCR-03 · Element: 901 · Name: Reject Reason Code · Type: Identifier (ID) · Requirement: Optional · Min: 2 · Max: 2 · Repeat: -

Code assigned by issuer to identify reason for rejection.

Position: HCR-04 · Element: 1073 · Name: Yes/No Condition or Response Code · Type: Identifier (ID) · Requirement: Optional · Min: 1 · Max: 1 · Repeat: -

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.