Purchased Services Attachment (PS)

The  Purchased Services Attachment is used to capture purchased service information that may be required on the claim. When a provider contracts with another provider or vendor to perform the technical component of a diagnostic test. For example, laboratory tests.

 

 

Data Field Information
Prompt Response Req Len
Referral Source Enter the code you want or click the magnifying glass to search the table.   1
Purchased From (NPI) Informational Only - Displays the NPI number for the referral source selected.   1
Price Enter the price.  

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