HCR01 — Action Code (X12 element 1371)
A4 — Pended
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (X12 005010X217 TR3 — verify against licensed copy). Do not rely on it for production configuration until this notice is removed.
How A4 is used
Returned in HCR01 while the review is open; follow-up communication (what is needed, from whom, by when) determines whether the pend resolves inside the SLA window.
Example
A request pends with HCR01 = A4 awaiting clinical notes; the UM team's dashboard tracks it against the 7-day clock.
Where it lives in the transaction
A4 is a value of HCR01 — Action Code (X12 element 1371), carried in the HCR (Health Care Services Review), 278 response of the 278 Health Care Services Review — Response (005010X217). For the payer-side view of how PA Bridge normalizes these codes across X12 and FHIR intake, see the articles section.