Transaction Details

Additional information related to an authorization request. One of these records is required for each authorization request record.

Transaction ID	Transaction Description	Status	Status Date
950.00	Additional Authorization Information	Final	7/7/2006

Key	Field ID	Field Code	Field Name	Field Description	Actions Allowed	Char Length
	101073	CV01	RCODE	Transaction ID	NN	6
	030010	CV02	RACTION	Action Code	NN	1
	030760	CV03	RSNID	RSN Report Unit	NN	3
K	030020	CV04	RORG	Agency Reporting Unit ID	NN	5
K	030001	CV05	RLGUID	Unique Identifier	NN	11
	030620	CV06	PN	Master Client Number	NN	11
	200602	RV01	pgname	Parent/Guardian Name	LA	40
	200604	RV02	iaidate	Intake Assessment Initiated Date	NA	8
	200606	RV03	extreq	Extension Requested by	NA	1
	200607	RV04	reasdel	Documented Reason for Assessment Delay	LA	1024
	200608	RV05	authtyp	Expedited Authorization Flag	LA	1
	200609	RV06	level	Level	NA	2
	200640	RV07	addlinfo	Add'l Information to Consider	LA	1024
	200641	RV08	presprob	Client's Presenting Problem at Access	NA	1024
	200631	RV09	bqual1	High Risk Behavior Previous 90-days	LA	1
	200632	RV10	bqual2	2+ I/P admits due to MH dx during prev. 2-yrs	LA	1
	200633	RV11	bqual3	Psych. Res. Tx LOS>=6mos or D/C now from psych I/P	LA	1
	200634	RV12	bqual4	Prior Public O/P MH Tx during prev. 90-days	LA	1
	200635	RV13	bqual5	Child Only-At risk of escalating symptoms due…	LA	1
	200636	RV14	bqual6	Child Age<6 - Atypical Behavioral Patterns…	LA	1
	200637	RV15	bqual7	Child Age<6 - Atypical Emotional Response…	LA	1
	200611	RV16	ax1pri	Diagnosis - Axis I - Primary	NA	6
	200612	RV17	ax1sec	Diagnosis - Axis I - Secondary	LA	6
	200613	RV18	ax1ter	Diagnosis - Axis I - Tertiary	LA	6
	200614	RV19	ax2pri	Diagnosis - Axis II - Primary	NA	6
	200615	RV20	ax2sec	Diagnosis - Axis II - Secondary	LA	6
	200616	RV21	ax2ter	Diagnosis - Axis II - Tertiary	LA	6
	200617	RV22	ax3	Diagnosis - Axis III	LA	1024
	200618	RV23	ax4pri	Diagnosis - Axis IV - Primary	LA	1
	200619	RV24	ax4sec	Diagnosis - Axis IV - Secondary	LA	1
	200620	RV25	ax4ter	Diagnosis - Axis IV - Tertiary	LA	1
	200621	RV26	ax5	Diagnosis - Axis V	NA	3

Field ID	Validation	CodeTable
030001	001 - Value Cannot Be Null
030010	001 - Value Cannot Be Null
030010	002 - Code Invalid	ACODE
030020	001 - Value Cannot Be Null
030020	002 - Code Invalid	ORG
030620	001 - Value Cannot Be Null
030760	001 - Value Cannot Be Null
101073	001 - Value Cannot Be Null
200604	001 - Value Cannot Be Null
200604	020 - Date may not be in the future.
200606	001 - Value Cannot Be Null
200606	002 - Code Invalid	AERB
200609	001 - Value Cannot Be Null
200609	002 - Code Invalid	LCARE
200611	001 - Value Cannot Be Null
200611	002 - Code Invalid	AXIS1
200612	002 - Code Invalid	AXIS1
200613	002 - Code Invalid	AXIS1
200614	001 - Value Cannot Be Null
200614	002 - Code Invalid	AXIS2
200615	002 - Code Invalid	AXIS2
200616	002 - Code Invalid	AXIS2
200618	002 - Code Invalid	AXIS4
200619	002 - Code Invalid	AXIS4
200620	002 - Code Invalid	AXIS4
200621	001 - Value Cannot Be Null
200621	901 - Numeric range 0 to 100
200641	001 - Value Cannot Be Null

Note_Date	Note
	See the NSMHA Clinical Eligibility and Care Standards for non-abbreviated additional criteria for Diagnosis B.
	Intake Assessment Initiated Date - This value is populated based off the first intake assessment service provided at the agency. For those clients where the original assessment date is not in the Provider CIS, use the date of the last re-auth.
	Expedited Authorization - determined at Access and entered into the I.S. by Access.
	Primary Diagnosis Rule-Outs: When the primary diagnosis is a rule-out, the first seven (7) characters in RADAU:addlinfo will be 'ruleout' sans quotes.
	B-Diagnosis qualifiers are not required on re-authorizations. An authorization request is considered a re-authorization when the value of RAUTR:certtyp = 'R'.

North Sound
Mental Health Administration

NSMHA-CIS Data Dictionary

Additional Authorization Information

Transaction

Transaction Details

Validations

Transaction Notes

North Sound Mental Health Administration

NSMHA-CIS Data Dictionary

Additional Authorization Information

Transaction

Transaction Details

Validations

Transaction Notes

North Sound
Mental Health Administration