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Attached Paperwork Type Descriptions for Electronic Claims
Posted: January 2, 2013

The 5010 Claim Code tab contains a field called Attached Paperwork Type. However, the descriptions were too long to include in a dropdown list.

The following list will give a full description of all “types”:

Type      Description

03           Report Justifying Treatment Beyond Utilization Guidelines

04          Drugs Administered

05          Treatment Diagnosis

06          Initial Assessment

07          Functional Goals

08          Plan of Treatment

09          Progress Report

10           Continued Treatment

11          Chemical Analysis

13          Certified Test Report

15          Justification for Admission

21           Recovery Plan

A3           Allergies/Sensitivities Document

A4           Autopsy Report

AM         Ambulance Certification

BR          Benchmark Testing Results

BS           Baseline

BT           Blanket Test Results

CB          Chiropractic Justification

CK          Consent Form(s)

D2           Drug Profile Document

DB         Durable Medical Equipment Prescription

DJ          Discharge Monitoring Report

HC        Health Certificate

HR          Health Clinic Records

I5            Immunization Record

IR           State School Immunization Records

LA           Laboratory Results

M1        Medical Record Attachment

OC          Oxygen Content Averaging Report

OD         Orders and Treatments Document

OE         Objective Physical Examination (including vital signs) Document

OX          Oxygen Therapy Certification

P4          Pathology Report

P5          Patient Medical History Document

PE           Parenteral or Enteral Certification

PQ         Paramedical Results

PY          Physician’s Report

RX          Renewable Oxygen Content Averaging Report

SG         Symptoms Document

V5          Death Notification

XP          Photographs

FT          File Transfer





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