Code
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Display
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Definition
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clinical
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Clinical Documentation |
Details most likely to originate from a clinician are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by clinician. Indicates that the CRD client should expose the need to launch DTR to clinical users. |
admin
|
Administrative Documentation |
Administrative details not likely to require clinical expertise are needed to satisfy additional documentation requirements, determine coverage and/or prior auth applicability - e.g. via DTR by back-end staff. Indicates that while the CRD client might expose the ability to launch DTR as an option for clinical users, it should be clear that clinical input is not necessary and deferring the use of DTR to back-end staff is perfectly appropriate. Some CRD clients might be configured (based on provider preference) to not even show clinicians the option to launch. |
both
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Administrative & clinical doc |
Both clinical and administrative details are required to satisfy additional documentation requirements, determine coverage and/or prior auth applicability. Equivalent to the union of #admin and #clinical. |
conditional
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Conditional |
Decision cannot be made without more information (more detailed code, service rendering information, etc.) |