REF

Service Authorization Exception Code

Pos: 180	Max: 1
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

4N

Special Payment Reference Number

REF02

127

Reference Identification
Description: Reference information as defined for a particular Transaction Set or as specified by the Reference Identification Qualifier
Industry: Service Authorization Exception Code

C

AN

1/30

Required

Code

Name

1

Immediate/Urgent Care

2

Services rendered in a retroactive period

3

Emergency care

4

Client as temporary Medicaid

5

Request from County for second opinion to recipient can work

6

Request for override pending

7

Special handling

1.

R0203 - At least one of REF02,REF03 is required

1.

REF04 contains data relating to the value cited in REF02.

Notes:

1. Used only in claims where providers are required by state law (e.g., New York State Medicaid) to obtain authorization for specific services but, for the reasons listed in REF02, performed the services without obtaining the service authorization. Check with your state Medicaid to see if this applies in your state.

Example:

REF*4N*1~