Table 0339: Advanced Beneficiary Notice Code
Table of codes specifying the status of the patient's or the patient's representative's consent for responsibility to pay for potentially uninsured services. This element was introduced to satisfy CMS Medical Necessity requirements for outpatient services in the United States. Includes concepts such as (a) whether the associated diagnosis codes for the service are subject to medical necessity procedures, (b) whether, for this type of service, the patient has been informed that they may be responsible for payment for the service, and (c) whether the patient agrees to be billed for this service.
- Type
- User-defined (site-defined)
- Codes
- 4
- Introduced
- HL7 v2.3.1
- Used in
- ORC-20, FT1-27
- THO code system
http://terminology.hl7.org/CodeSystem/v2-0339- OID
2.16.840.1.113883.18.209
User-defined (site-defined): HL7 suggests these values, and each site may use its own. PipeHat notes codes outside this list as information, not errors.
Codes
| Code | Meaning |
|---|---|
1 | Service is subject to medical necessity procedures |
2 | Patient has been informed of responsibility, and agrees to pay for service |
3 | Patient has been informed of responsibility, and asks that the payer be billed |
4 | Advanced Beneficiary Notice has not been signed |
Where it's used
| Element | Name | FHIR (v2-to-FHIR mapping) |
|---|---|---|
ORC-20 | Advanced Beneficiary Notice Code | — |
FT1-27 | — |
Elements with a dot (such as CX.5) are data type components, used wherever that data type appears.
Source: HL7 Terminology (THO) 7.4.0 and the HL7 v2-to-FHIR Implementation Guide 1.0.0, published by HL7 International under CC0. Check your trading partner's specification for the values they actually send.