UM03 — Service Type Code (X12 element 1365)
81 — Routine Physical
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 81 is used
Presence in a 278 usually signals an intake configuration issue rather than a genuine review need.
Example
An automated intake flags UM03 = 81 as no-auth-required and returns an immediate response.
Where it lives in the transaction
81 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.