UM02 — Certification Type Code (X12 element 1322)
1 — Appeal — Immediate
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 1 is used
Sent in UM02 with reference to the certification being appealed. Plans typically route these to expedited clinical review queues with tighter turnaround clocks than standard appeals.
Example
An inpatient stay is denied while the patient is still admitted; the facility files UM02 = 1 to trigger an immediate appeal.
Where it lives in the transaction
1 is a value of UM02 — Certification Type Code (X12 element 1322), 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.