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Data Element
CIP027
CIP.002.027
No Updates
Definition | Claim adjustment reason codes communicate why a claim was paid differently than it was billed. |
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Size | X(3) |
FLF Start Position | 159 |
FLF Stop Position | 161 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be in Adjustment Reason Code List (VVL) 2. Value must be 3 characters or less 3. Conditional 4. Value must be populated when the total paid amount is different from the total billed amount |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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CLT026 | CLT.002.026 | ADJUSTMENT-REASON-CODE | CLT00002 | CLAIM-HEADER-RECORD-LT |
COT026 | COT.002.026 | ADJUSTMENT-REASON-CODE | COT00002 | CLAIM-HEADER-RECORD-OT |
CRX026 | CRX.002.026 | ADJUSTMENT-REASON-CODE | CRX00002 | CLAIM-HEADER-RECORD-RX |