1351 Patient Signature Source Code

Code indicating how the patient or subscriber authorization signatures were obtained and how they are being retained by the provider

Identifier (ID)
Min 1 / Max 1
BSigned signature authorization form or forms for both HCFA-1500 Claim Form block 12 and block 13 are on file
CSigned HCFA-1500 Claim Form on file
MSigned signature authorization form for HCFA-1500 Claim Form block 13 on file
PSignature generated by provider because the patient was not physically present for services
SSigned signature authorization form for HCFA-1500 Claim Form block 12 on file

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