UM03 — Service Type Code (X12 element 1365)
20 — Second Surgical Opinion
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (X12 element 1365 external code list — verify against licensed copy). Do not rely on it for production configuration until this notice is removed.
How 20 is used
Sent in UM03 when the review concerns the second-opinion visit itself rather than the surgery under consideration.
Example
UM03 = 20 for a plan-required second opinion prior to elective back surgery.
Where it lives in the transaction
20 is a value of UM03 — Service Type Code (X12 element 1365), carried in the UM (Health Care Services Review Information); same element is used in EQ01 of the 270/271 of the 278 Health Care Services Review (005010X217). For the payer-side view of how PA Bridge normalizes these codes across X12 and FHIR intake, see the articles section.