Code | Display | abstract | abstract | Comments |
---|
prior-auth-include | Include in prior authorization | | | |
initial-claim-include | Include in initial claim | | | |
all-claims-include | Include in all claims | | | |
reason-prior-auth | Prior authorization | | | |
after-completion-action | After-completion action | | | |
gold-card | Gold card | | | |
detail-code | Detail code | | | |
allowed-quantity | Maximum quantity | | | |
allowed-period | Maximum allowed period | | | |
in-network-copay | Copay for in-network | | | |
out-network-copay | Copay for out-of-network | | | |
auth-out-network-only | Authorization out-of-network only | | | |
concurrent-review | Concurrent review | | | |
appropriate-use-needed | Appropriate use | | | |
policy-link | Policy Link | | | |
instructions | Instructions | | | |
conditional | Conditional | | | |
covered | Covered | | | |
not-covered | Not covered | | | |
clinical | Clinical Documentation | | | |
admin | Administrative Documentation | | | |
both | Administrative & clinical doc | | | |
patient | Administrative & clinical doc | | | |
no-auth | No Prior Authorization | | | |
auth-needed | Prior Authorization Needed | | | |
satisfied | Authorization Satisfied | | | |
performer | Performer Needed | | | |
location | Location Needed | | | |
timeframe | Timeframe Needed | | | |
contract-window | New Contract Window | | | |
used | Authorization Token Used | | | |
not-used | Authorization Token Not Used | | | |
provider-src | Provider-sourced | | | |
payer-src | Payer-sourced | | | |
_cardType | Card Type (abstract) | BooleanType[true] | | BooleanType[true] | | |
_HookType | CDS Hook Type (abstract) | BooleanType[true] | | BooleanType[true] | | |
_docReason | Additional Information Purposes | BooleanType[true] | | BooleanType[true] | | |
_cmsLocation | CMS Location codes | | | |