REF

Prior Authorization or Referral Number

Pos: 180	Max: 2
Detail - Optional
Loop: 2300	Elements: 2

Ref

Id

Element Name

Req

Type

Min/Max

Usage

REF01

128

Reference Identification Qualifier
Description: Code qualifying the Reference Identification

M

ID

2/3

Required

Code

Name

9F

Referral Number

G1

Prior Authorization Number

Description: An authorization number acquired prior to the submission of a claim

REF02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Prior Authorization Number
UB-92 Ref. [UB-Name]: 63 (A-C) [Treatment Authorization Code]
EMC v.6.0 Reference: Record Type 40 Field No. 5, 6, 7 (Treatment Authorization Number)

C

AN

1/30

Required

1.

R0203 - At least one of REF02,REF03 is required

1.

REF04 contains data relating to the value cited in REF02.

Notes:

1. Required where services on this claim were preauthorized or where a referral is involved. Generally, preauthorization/referral numbers are those numbers assigned by the payer/UMO to authorize a service prior to its being performed. The UMO (Utilization Management Organization) is generally the entity empowered to make a decision regarding the outcome of a health services review or the owner of information. The referral or prior authorization number carried in this REF is specific to the destination payer reported in the 2010BC loop. If other payers have similar numbers for this claim, report that information in the 2330 loop REF which holds that payer’s information.

Example:

REF*G1*200398~