UM02 — Certification Type Code (X12 element 1322)
2 — Appeal — Standard
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 2 is used
Sent in UM02 with reference to the original certification or denial. Carries supporting information justifying why the determination should be reversed.
Example
A denied MRI authorization is appealed after the ordering physician documents failed conservative treatment: UM02 = 2.
Where it lives in the transaction
2 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.