| Description | Indicates the status of the patient's or the patient's representative's consent for responsibility to pay for potentially uninsured services. This element is introduced to satisfy CMS Medical Necessity requirements for outpatient services. This element indicates (a) whether the associated diagnosis codes for the service are subject to medical necessity procedures (b) whether, for this type of service, the patient has been informed that they may be responsible for payment for the service, and (c) whether the patient agrees to be billed for this service.
For Example:
Service is subject to medical necessity procedures
Patient has been informed of responsibility, and agrees to pay for service
Patient has been informed of responsibility, and asks that the payer be billed
Advanced Beneficiary Notice has not been signed
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