Standards & EDI
UM01 Request Category Code
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
Request category drives payer-side routing — admissions to concurrent-review teams, services to the general PA queue, referrals to gatekeeper logic. It pairs with UM02 (certification type) to fully classify the request: category says what is reviewed, type says where in the certification lifecycle the request sits.