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: 1

Code indicating type of action

Position: HCR-02 · Element: 127 · Name: Reference Identification · Type: String (AN) · Requirement: Optional · Min: 1 · Max: 50 · Repeat: 1

Reference information as defined for a particular Transaction Set or as specified by the Reference Identification 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: 1

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: 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.