ASC X12 004010

1351 Patient Signature Source Code
TYPE=ID MIN=1 MAX=1

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


B        Signed signature authorization form or forms for both HCFA-1500 Claim Form 
         block 12 and block 13 are on file
C        Signed HCFA-1500 Claim Form on file
M        Signed signature authorization form for HCFA-1500 Claim Form block 13 on file
P        Signature generated by provider because the patient was not physically present 
         for services
S        Signed signature authorization form for HCFA-1500 Claim Form block 12 on file