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Code
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Display
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Definition
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no-auth
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No Prior Authorization |
The ordered service does not require prior authorization |
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auth-needed
|
Prior Authorization Needed |
The ordered service will require prior authorization |
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satisfied
|
Authorization Satisfied |
While prior authorization would typically be needed, the conditions evaluated by prior authorization have already been evaluated and therefore prior authorization can be bypassed |
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performpa
|
Performer Prior Authorization |
Prior authorization is needed for the service, however such prior authoriation must be initiated by the performing (rather than ordering) provider. |
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conditional
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Conditional |
Decision cannot be made without more information (more detailed code, service rendering information, etc.) |