UM03 — Service Type Code (X12 element 1365)
AI — Substance Abuse
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 AI is used
Sent in UM03 for SUD treatment review; level-of-care criteria (e.g., ASAM-based) drive determinations.
Example
UM03 = AI for residential SUD treatment certification.
Where it lives in the transaction
AI 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.