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

Identifier (ID)

Length

Min 1 / Max 1

Codes

Code	Description
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