| Name | Value |
|---|---|
| FORM FIELD REFERENCE | CMS-1500 |
| SECURITY LEVEL | NATIONAL,NO EDIT |
| DATA ELEMENT | N-CURRENT AUTH/REFERRAL CODE |
| PAD CHARACTER | NO PAD REQUIRED |
| FORMAT CODE | I $$OLAB^IBCEU(IBXIEN) N IBZ S IBZ=IBXDATA D F^IBCEF("N-LAB CLIA #",,,IBXIEN) I IBXDATA="",IBZ'="" S IBXDATA=IBZ |
| FORMAT CODE DESCRIPTION | If the bill is for services rendered at an outside lab, get the CLIA number. If this # is not available, use the prior authorization #. |