Segment
X12 EDI Release 00304
To specify the adjudication codes for a claim service item
Elements
  • CA1011353Payment Status Code
    ID
    M必须(Mandatory)

    Code indicating the result of insurance claim payment processing by another payor

    Codes (3)
  • CA1021034Claim Adjustment Reason Code
    ID
    O可选(Optional)
    Min 1 / Max 5

    Code identifying the detailed reason the adjustment was made.

  • CA1031034Claim Adjustment Reason Code
    ID
    O可选(Optional)
    Min 1 / Max 5

    Code identifying the detailed reason the adjustment was made.

  • CA1041034Claim Adjustment Reason Code
    ID
    O可选(Optional)
    Min 1 / Max 5

    Code identifying the detailed reason the adjustment was made.