Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Non-Institutional
|
2-280
|
Up to 99
|
Yes
|
Primary Picture (Format)
|
Two (2) alphanumeric characters.
|
Definition
|
Code to indicate the type of
service provided. Contractors should use their best business practices
to assign second position type of service value.
|
Code/Value Specifications
|
TYPE OF
SERVICE CODES - FIRST POSITION VALUES
|
|
A
|
Ambulatory surgery cost-shared
as inpatient (ADFMs only)
|
|
I
|
Inpatient
|
|
K
|
Emergency Room Admission cost-shared
as inpatient.
|
|
M
|
Outpatient maternity care cost-shared
as inpatient
|
|
N
|
Outpatient cost-shared as inpatient
|
|
O
|
Outpatient, excluding M, N,
or P
|
|
P1
|
Outpatient partial psychiatric
hospitalization care cost-shared as inpatient
|
|
TYPE OF
SERVICE CODES - SECOND POSITION VALUES
|
|
1
|
Medical Care
|
|
2
|
Surgery
|
|
3
|
Consultation
|
|
4
|
Diagnostic/Therapeutic X-Ray
|
|
5
|
Diagnostic Laboratory
|
|
6
|
Radiation Therapy
|
|
7
|
Anesthesia
|
|
8
|
Assistance at Surgery
|
|
9
|
Other Medical Services &
Supplies
|
|
A
|
DME Rental/Purchase
|
|
B
|
Retail Drugs, Supplies, Prescription
Authorizations, and Reviews
|
|
C2
|
Ambulatory Surgery
|
|
D
|
Hospice
|
|
E
|
Second Opinion on Elective
Surgery
|
|
F
|
Maternity
|
|
G
|
Dental
|
|
H
|
Mental Health Care
|
|
I
|
Ambulance
|
|
J
|
ECHO (formerly PFPWD)
|
|
K
|
Physical/Occupational Therapy
|
|
L
|
Speech Therapy
|
|
M
|
Mail Order Pharmacy (MOP) Drugs,
Supplies, Prescription Authorizations, and Reviews
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
N/A
|