Lookup Indicator - Report the value that defines the MC 11/8/12 Table - int[1] Authorization element. EXAMPLE: 1 = Yes All 100% A2 Needed Integer Needed service required a pre-authorization. Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable Lookup Report the value that defines the Referral Indicator - Referral MC 11/8/12 Table - int[1] element. EXAMPLE: 1 = Yes All 100% A0 18 Indicator Needed Integer service was preceded by a referral. Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable Report the value that defines the Lookup PCP Indicator - PCP element. EXAMPLE: 1 = Yes MC 11/8/12 Table - int[1] All 100% A2 Indicator Rendered Service service was performed by members Integer PCP. Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable
MC Needed 11/8/12 Lookup Table - Integer int[1] Indicator - Authorization Needed Report the value that defines the element. EXAMPLE: 1 = Yes service required a pre-authorization. All 100% A2 Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable MC Referral Indicator 11/8/12 Lookup Table - Integer int[1] Indicator - Referral Needed Report the value that defines the element. EXAMPLE: 1 = Yes service was preceded by a referral. All 100% A0 Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable MC PCP Indicator 11/8/12 Lookup Table - Integer int[1] Indicator - PCP Rendered Service Report the value that defines the element. EXAMPLE: 1 = Yes service was performed by members PCP. All 100% A2 Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable 18