Segment
X12 EDI Release 00501
To convey the status of a product service claim or claims or to supply adjustment reason codes and amounts as needed for an entire claim or for a particular item within the claim
Elements
Code identifying the status of an entire claim as assigned by the payor, claim review organization or repricing organization
Codes (41)- 1Processed as Primary
- 2Processed as Secondary
- 3Processed as Tertiary
- 4Denied
- 5Pended
- 6Approved as amended
- 7Approved as submitted
- 8Cancelled due to inactivity
- 9Pending - under investigation
- 10Received, but not in process
- 11Rejected, duplicate claim
- 12Rejected, please resubmit with corrections
- 13Suspended
- 14Suspended - incomplete claim
- 15Suspended - investigation with field
- 16Suspended - return with material
- 17Suspended - review pending
- 18Suspended Product Registration
- 19Processed as Primary, Forwarded to Additional Payer(s)
- 20Processed as Secondary, Forwarded to Additional Payer(s)
- 21Processed as Tertiary, Forwarded to Additional Payer(s)
- 22Reversal of Previous Payment
- 23Not Our Claim, Forwarded to Additional Payer(s)
- 24Transferred to Proper Carrier
- 25Predetermination Pricing Only - No Payment
- 26Documentation Claim - No Payment Associated
- 27Reviewed
- 28Repriced
- 29Audited
- 30Processed as Conditional
- IInitial
- ADAdditional
- APAppealed
- CCWeekly Certification
- CLClosed
- CPOpen
- RAReaudited
- RBReissue
- RCReopened and Closed
- RDRedetermination
- ROReopened
Code identifying the agency assigning the code values
Codes (194)- 10Alabama
- 11Alaska
- 12Arizona
- 13Arkansas
- 14California
- 15Colorado
- 16Connecticut
- 17Delaware
- 18District of Columbia
- 19Florida
- 20Georgia
- 21Hawaii
- 22Idaho
- 23Illinois
- 24Indiana
- 25Iowa
- 26Kansas
- 27Louisiana
- 28Kentucky
- 29Maine
- 30Maryland
- 31Massachusetts
- 32Michigan
- 33Minnesota
- 34Mississippi
- 35Missouri
- 36Montana
- 37Nebraska
- 38Nevada
- 39New Hampshire
- 40New Jersey
- 41New Mexico
- 42New York
- 43North Carolina
- 44North Dakota
- 45Ohio
- 46Oklahoma
- 47Oregon
- 48Pennsylvania
- 49Rhode Island
- 50South Carolina
- 51South Dakota
- 52Tennessee
- 53Texas
- 54Utah
- 55Vermont
- 56Virginia
- 57Washington
- 58West Virginia
- 59Wisconsin
- 60Wyoming
- 61Insurance Services Office (ISO)
- 62National Crime Information Center (NCIC)
- 64U.S. National Center for Health Statistics Commission of Professional and Hospital Activities
- 65Office of Workers Compensation Programs
- 66National Association of Convenience Stores
- 93Dun & Bradstreet
- 94Code Assigned by the Organization that is the Ultimate Destination of the Transaction Set
- A1American Land Title Association
- A2California Land Title Association
- A3Texas Land Title Association
- A4Assigned by Carrier
- AAAluminum Association
- ABAssigned by Buyer
- ACAmerican Conference of Government Industrial Hygienists (ACGIH)
- ADAgency Company Organization for Research and Development (ACORD)
- AEAdvertising Industry
- AFAutomotive Aftermarket Industry Association (AAIA)
- AGState Agency Assigned
- AHAmerican Industrial Hygiene Association (AIHA)
- AJReal Estate Information Industry
- ALNational Alcohol Beverage Control Association
- AMAmerican Medical Association
- APAmerican Petroleum Institute
- AQAmerican Public Works Association (APWA) One Call Systems International (OCSI)
- ARAssociation of American Railroads
- ASAssigned by Seller
- ATAmerican Society for Testing and Materials (ASTM)
- AWAmerican Welding Society (AWS)
- AXANSI Accredited Standards Committee, X12
- AYAmerican Yarn Spinners Association (AYSA)
- BABusiness and Institutional Furniture Manufacturer's Association (BIFMA)
- BETelcordia Technologies
- BFNational Business Forms Association
- BIBook Industry Systems Advisory Committee
- CAChemical Abstract Services (CAS)
- CBCopper and Brass Fabricators Council, Inc.
- CCNational Cotton Council of America
- CEConstruction Specification Institute (CSI) Extended
- CIChemical Industry Data Exchange (CIDX)
- CLCollision Industry Electronic Commerce Association (CIECA)
- CMCarbide Manufacturers
- COCounty Designator Code
- CPUnited States Department of Agriculture, Agricultural Marketing Service (AMS), Cotton Programs
- CRCommander - Rome Air Development Center
- CSConstruction Specification Institute (CSI)
- CUCommittee on Uniform Security Identification Procedures (CUSIP)
- CXNational Association of Corrosion Engineers (NACE)
- DAFood and Drug Administration (FDA)
- DDDepartment of Defense (Military Specifications)
- DEDrug Enforcement Administration
- DFDepartment of Defense (DoD)
- DHDefense Logistics Information Service
- DIDeutsches Institut fur Normung (DIN)
- DLDefense Logistics Agency
- DNDepartment of the Navy
- DOUnited States Department of Transportation (DOT)
- DRHealthcare Distribution Management Association
- DSDefense Finance and Accounting Service (DFAS)
- DXUnited States Marine Corps
- DYDepartment of Air Force
- DZDepartment of Army
- EIElectronic Industries Association
- EPUnited States Environmental Protection Agency (EPA)
- ESEnvironment and Safety Data Exchange (ESDX)
- ETTemporary Help Industry
- EUElectric Utilities
- EXElectronics Industry Data Exchange (EIDX)
- FAFabric and Supplier Linkage Council (FASLINC)
- FCFederal Communications Commission (FCC)
- FDGS1 US, Inc.
- FGFederal Government
- FHFederal Highway Administration
- FIAmerican Furniture Manufacturers Association
- GCGraphics Communications Association
- GINorth American Energy Standards Board
- GSGeneral Services Administration (GSA)
- GUNatural Gas Utilities
- HCCenters for Medicare and Medicaid Services
- HFHuman Factors and Ergonomics Society
- HIHealth Insurance Association of America
- HSDepartment of Health and Human Services
- HUDepartment of Housing and Urban Development
- IAInternational Agency for Research on Cancer (IARC)
- IBInternational Association of Industrial Accident Boards and Commissions
- ICInternational Air Transport Association (IATA)
- IMIron and Steel Standards Committee ISM
- INInternational Association of Corporation Administrators
- ISInternational Standards Organization
- JAJapanese Standards Association
- LALife and Annuity Industry Committee
- LBDepartment of Labor
- LILeasing Industry
- MAMortgage Bankers Association of America
- MBOffice of Management and Budget
- MCManufacturing Company
- MEAmerican Society of Mechanical Engineers (ASME)
- MIABCD - The Microcomputer Industry Association
- MPMaterial Safety Data Sheet (MSDS) Provider
- MSMilitary Standard
- MVAmerican Association of Motor Vehicle Administrators (AAMVA)
- NANational Insurance Crime Bureau (NICB)
- NBNational Association of Business and Educational Radio
- NCNational Council on Compensation Insurance
- NENational Electric Manufacturers Association (NEMA)
- NFNational Fire Protection Agency (NFPA)
- NGNational Auto Glass Specification (NAGS)
- NINational Institute of Occupational Safety and Health (NIOSH)
- NPNational Association of Pharmacy Regulatory Authorities (NAPRA)
- NRNational Retail Merchants Association
- NSNational Center for State Courts
- NTNational Toxicology Program (NTP)
- NUUnited States Nuclear Regulatory Commission
- NWNewspaper Association of America
- OIOptical Industry
- OPOffice Products
- OSUnited States Occupational Safety and Health Administration (OSHA)
- PAAmerican Paper Institute
- PCPennsylvania Courts
- PISociety of the Plastics Industry (SPI)
- RNRosettaNet
- SASociety of Automotive Engineers, Inc. (SAE)
- SESerials Industry Systems Advisory Committee (SISAC)
- SLStudent Loan Guarantor
- SPAmerican Society for Automation in Pharmacy
- STAmerican Iron & Steel Institute
- TAAir Transport Association of America
- TBTextile Distributors Association, Inc.
- TCTextile Apparel Linkage Council (TALC)
- TDTransportation Data Coordinating Committee: Electronic Data Interchange Association (TDCC:EDIA)
- TITelecommunications Industry
- TMAmerican Textile Manufacturers Institute
- TPCanadian Freight Classification
- TRAmerican Trucking Associations
- TXAmerican Apparel Manufacturers Association
- UA(UN/SPSC) United Nations Products and Services Classification Code
- UCUnited States Courts
- UIIndustrial/Commercial (I/C) Electronic Data Interchange
- ULUnderwriters Laboratories
- UNUnited Nations (UN)
- UTUtility Industry Group
- VIVoluntary Inter-Industry Commerce Standard (VICS) EDI
- WHCanadian Workplace Hazardous Materials Information System (WHMIS)
- ZZMutually Defined
Code identifying the detailed reason for the response
Codes (82)- A1Inappropriate Standard Repair Time Used
- A2Date on Claim Different than Supporting Document
- A3Submit as Field Service Claim
- A4Missing Part Number
- A5Must Submit Serial Number of Major Component
- A6Submit as Product Improvement Claim
- ACAmount Claimed Exceeds Authorization Amount
- CCClaim Cancelled By Claimant
- CHCore Charge Not Allowed
- CPClaim Pending - Subject to Supplier Approval
- CSClaim Submitted Too Late to Accept
- DCDuplicate Charge
- DEDeductible Exceeds Claimed Amount
- DIDamages Caused by Improper Vehicle Operation
- DNDiscrepancy Not Noted on Delivery Receipt
- EFExcess Freight Charges
- ELExcess Lube Charges
- EWExpired Warranty
- FCFile Claim Directly to Supplier
- HDHandling Disallowed or Reduced
- IAIncorrect Associate Account
- IIInvalid Standard Repair Time Used
- ILIncorrect Labor Rate
- IRImproper Repair Procedures
- IVInvalid Vehicle Identification Number (VIN)
- LCLubricant Charge Not Allowed
- LDLabor Disallowed
- LOLabor Overlap
- MCMileage on Claim Different Than Supporting Document
- MHMust Submit Model Number of Major Component
- NFNeed Fuel Tank Scrap Form
- OCOther Charges Not Allowed
- OROnly One Repair Allowed Per Section
- PBProduct Built to Spec
- PDPart Damaged - Cannot Establish Defect
- PRPhoto Required - Resubmit Claim and Mail Photo
- RPReplacement Part Information is Incorrect
- RTResubmit as Transporter Claim
- SASpecial Adjustment
- SMSubmit as Recall Claim
- SPSubmit as a Replacement Parts Claim
- SRStorage Related Problem - Not Our Responsibility
- SWSubmit as Warranty Claim
- TCTowing Charge Exceeds Warranty Allowance
- URUnauthorized Repair
- VBVehicle Not Built to Order
- VMVehicle Modification
- VUVehicle Already Paid Per Specified Claim
- WCWrong Causal Part Number
- WMWrong Part Number
- CDRCustomer Damage or Responsibility
- CMPCustomer Must Pay Deductible
- ELHExcessive Labor Hours
- ELRExcessive Labor Rate
- EPCExcessive Part Cost
- ESCExcessive Sublet Cost
- FRSFactory Required Service
- FWCFull Warranty Credit
- IISInsufficient Information Supplied
- IRSItem Reported as Stolen
- IWSInsufficient Warranty Information Supplied
- MAPManufacturer's Agreed Price
- MRAMileage Less Than Previously Stated
- NCRNo Charge Repair
- NDFNo Defect Found
- NEWNot Eligible for Warranty
- NOPNot Our Product
- NRINot a Recall Item
- NSBNot a Service Bulletin Item
- NWRNo Warranty Record
- ODROriginal Equipment Manufacturer (OEM) or Manufacturer's Responsibility
- PNPPart not Proper for Specified Repair
- PNRPart or Documentation Not Returned or Received Within Time Limit
- PRDPart Received Damaged Due to Dealer Poor Packaging
- PWAPartial Warranty Approved
- RDPRepair Description Does Not Agree With Product
- RDRRepair Facility's Responsibility
- SUBSubmitted Too Late
- UPRUnrelated To Previous Repair
- URFUnauthorized Repair Facility
- VPWVehicle Previously Wrecked, System Not Warranted
- WBSWarranted By Seller
Code identifying follow-up actions allowed
Codes (10)- CPlease Correct and Resubmit
- DResubmit Entire Claim
- EResubmit This Item Only
- NResubmission Not Allowed
- PPlease Resubmit Original Transaction
- RResubmission Allowed
- SDo Not Resubmit; Inquiry Initiated to a Third Party
- WPlease Wait 30 Days and Resubmit
- XPlease Wait 10 Days and Resubmit
- YDo Not Resubmit; We Will Hold Your Request and Respond Again Shortly
Code identifying the agency assigning the code values
Codes (194)- 10Alabama
- 11Alaska
- 12Arizona
- 13Arkansas
- 14California
- 15Colorado
- 16Connecticut
- 17Delaware
- 18District of Columbia
- 19Florida
- 20Georgia
- 21Hawaii
- 22Idaho
- 23Illinois
- 24Indiana
- 25Iowa
- 26Kansas
- 27Louisiana
- 28Kentucky
- 29Maine
- 30Maryland
- 31Massachusetts
- 32Michigan
- 33Minnesota
- 34Mississippi
- 35Missouri
- 36Montana
- 37Nebraska
- 38Nevada
- 39New Hampshire
- 40New Jersey
- 41New Mexico
- 42New York
- 43North Carolina
- 44North Dakota
- 45Ohio
- 46Oklahoma
- 47Oregon
- 48Pennsylvania
- 49Rhode Island
- 50South Carolina
- 51South Dakota
- 52Tennessee
- 53Texas
- 54Utah
- 55Vermont
- 56Virginia
- 57Washington
- 58West Virginia
- 59Wisconsin
- 60Wyoming
- 61Insurance Services Office (ISO)
- 62National Crime Information Center (NCIC)
- 64U.S. National Center for Health Statistics Commission of Professional and Hospital Activities
- 65Office of Workers Compensation Programs
- 66National Association of Convenience Stores
- 93Dun & Bradstreet
- 94Code Assigned by the Organization that is the Ultimate Destination of the Transaction Set
- A1American Land Title Association
- A2California Land Title Association
- A3Texas Land Title Association
- A4Assigned by Carrier
- AAAluminum Association
- ABAssigned by Buyer
- ACAmerican Conference of Government Industrial Hygienists (ACGIH)
- ADAgency Company Organization for Research and Development (ACORD)
- AEAdvertising Industry
- AFAutomotive Aftermarket Industry Association (AAIA)
- AGState Agency Assigned
- AHAmerican Industrial Hygiene Association (AIHA)
- AJReal Estate Information Industry
- ALNational Alcohol Beverage Control Association
- AMAmerican Medical Association
- APAmerican Petroleum Institute
- AQAmerican Public Works Association (APWA) One Call Systems International (OCSI)
- ARAssociation of American Railroads
- ASAssigned by Seller
- ATAmerican Society for Testing and Materials (ASTM)
- AWAmerican Welding Society (AWS)
- AXANSI Accredited Standards Committee, X12
- AYAmerican Yarn Spinners Association (AYSA)
- BABusiness and Institutional Furniture Manufacturer's Association (BIFMA)
- BETelcordia Technologies
- BFNational Business Forms Association
- BIBook Industry Systems Advisory Committee
- CAChemical Abstract Services (CAS)
- CBCopper and Brass Fabricators Council, Inc.
- CCNational Cotton Council of America
- CEConstruction Specification Institute (CSI) Extended
- CIChemical Industry Data Exchange (CIDX)
- CLCollision Industry Electronic Commerce Association (CIECA)
- CMCarbide Manufacturers
- COCounty Designator Code
- CPUnited States Department of Agriculture, Agricultural Marketing Service (AMS), Cotton Programs
- CRCommander - Rome Air Development Center
- CSConstruction Specification Institute (CSI)
- CUCommittee on Uniform Security Identification Procedures (CUSIP)
- CXNational Association of Corrosion Engineers (NACE)
- DAFood and Drug Administration (FDA)
- DDDepartment of Defense (Military Specifications)
- DEDrug Enforcement Administration
- DFDepartment of Defense (DoD)
- DHDefense Logistics Information Service
- DIDeutsches Institut fur Normung (DIN)
- DLDefense Logistics Agency
- DNDepartment of the Navy
- DOUnited States Department of Transportation (DOT)
- DRHealthcare Distribution Management Association
- DSDefense Finance and Accounting Service (DFAS)
- DXUnited States Marine Corps
- DYDepartment of Air Force
- DZDepartment of Army
- EIElectronic Industries Association
- EPUnited States Environmental Protection Agency (EPA)
- ESEnvironment and Safety Data Exchange (ESDX)
- ETTemporary Help Industry
- EUElectric Utilities
- EXElectronics Industry Data Exchange (EIDX)
- FAFabric and Supplier Linkage Council (FASLINC)
- FCFederal Communications Commission (FCC)
- FDGS1 US, Inc.
- FGFederal Government
- FHFederal Highway Administration
- FIAmerican Furniture Manufacturers Association
- GCGraphics Communications Association
- GINorth American Energy Standards Board
- GSGeneral Services Administration (GSA)
- GUNatural Gas Utilities
- HCCenters for Medicare and Medicaid Services
- HFHuman Factors and Ergonomics Society
- HIHealth Insurance Association of America
- HSDepartment of Health and Human Services
- HUDepartment of Housing and Urban Development
- IAInternational Agency for Research on Cancer (IARC)
- IBInternational Association of Industrial Accident Boards and Commissions
- ICInternational Air Transport Association (IATA)
- IMIron and Steel Standards Committee ISM
- INInternational Association of Corporation Administrators
- ISInternational Standards Organization
- JAJapanese Standards Association
- LALife and Annuity Industry Committee
- LBDepartment of Labor
- LILeasing Industry
- MAMortgage Bankers Association of America
- MBOffice of Management and Budget
- MCManufacturing Company
- MEAmerican Society of Mechanical Engineers (ASME)
- MIABCD - The Microcomputer Industry Association
- MPMaterial Safety Data Sheet (MSDS) Provider
- MSMilitary Standard
- MVAmerican Association of Motor Vehicle Administrators (AAMVA)
- NANational Insurance Crime Bureau (NICB)
- NBNational Association of Business and Educational Radio
- NCNational Council on Compensation Insurance
- NENational Electric Manufacturers Association (NEMA)
- NFNational Fire Protection Agency (NFPA)
- NGNational Auto Glass Specification (NAGS)
- NINational Institute of Occupational Safety and Health (NIOSH)
- NPNational Association of Pharmacy Regulatory Authorities (NAPRA)
- NRNational Retail Merchants Association
- NSNational Center for State Courts
- NTNational Toxicology Program (NTP)
- NUUnited States Nuclear Regulatory Commission
- NWNewspaper Association of America
- OIOptical Industry
- OPOffice Products
- OSUnited States Occupational Safety and Health Administration (OSHA)
- PAAmerican Paper Institute
- PCPennsylvania Courts
- PISociety of the Plastics Industry (SPI)
- RNRosettaNet
- SASociety of Automotive Engineers, Inc. (SAE)
- SESerials Industry Systems Advisory Committee (SISAC)
- SLStudent Loan Guarantor
- SPAmerican Society for Automation in Pharmacy
- STAmerican Iron & Steel Institute
- TAAir Transport Association of America
- TBTextile Distributors Association, Inc.
- TCTextile Apparel Linkage Council (TALC)
- TDTransportation Data Coordinating Committee: Electronic Data Interchange Association (TDCC:EDIA)
- TITelecommunications Industry
- TMAmerican Textile Manufacturers Institute
- TPCanadian Freight Classification
- TRAmerican Trucking Associations
- TXAmerican Apparel Manufacturers Association
- UA(UN/SPSC) United Nations Products and Services Classification Code
- UCUnited States Courts
- UIIndustrial/Commercial (I/C) Electronic Data Interchange
- ULUnderwriters Laboratories
- UNUnited Nations (UN)
- UTUtility Industry Group
- VIVoluntary Inter-Industry Commerce Standard (VICS) EDI
- WHCanadian Workplace Hazardous Materials Information System (WHMIS)
- ZZMutually Defined