Reference X12 Release 5010 Elements 1364 Review Code
1364 Review CodeCode identifying extenuating circumstances or justifications which might assist any review of the medical necessity for this service Type Identifier (ID) Length Min 1 / Max 2 Codes Code Description ACase Turned Over to a Consultant BPre-Admission Testing CX-ray or Lab Procedure Related to a Covered Surgery DProvider/Supplier determined the service is not covered, but the patient is requesting a formal review by the payor EBeneficiary was notified that the item might not be considered medically necessary and has agreed in writing to pay for the item; A signed waiver is on file with the provider FBeneficiary was notified that the item might not be considered medically necessary and has not agreed to pay for the item; No signed waiver is on file with the provider LReserved for Local Assignment NReserved for National Assignment
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SV1 Professional ServiceStedi is a registered trademark of Stedi, Inc. Stedi's EDI Reference
is provided for marketing purposes and is free of
charge. All names, logos, and brands of third parties listed on our site
are trademarks of their respective owners (including “X12”, which is a
trademark of X12 Incorporated). Stedi, Inc. and its products and services
are not endorsed by, sponsored by, or affiliated with these third parties.
Our use of these names, logos, and brands is for identification purposes
only, and does not imply any such endorsement, sponsorship, or
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