UM01 — Request Category Code (X12 element 1525)
HS — Health Services Review
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 HS is used
Sent in UM01 when the request is for certification of specific services rather than an admission or a specialty-care referral. The services under review are described by the service type code (UM03), procedure codes in the SV segments, and diagnosis codes in the HI segment.
Example
A provider requests prior authorization for an outpatient MRI: UM01 = HS, with the service type and procedure details carried in the rest of the service loop.
Where it lives in the transaction
HS is a value of UM01 — Request Category Code (X12 element 1525), carried in the UM (Health Care Services Review Information), 2000E/2000F loops 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.