EDI Dictionary

Transaction Sets Segments

EDI-Dictionary

4010

1029

1029Claim Status Code

Batch

Code identifying the status of an entire claim as assigned by the payor, claim review organization or repricing organization

Element Details

Type ID

LengthMin 1 / Max 2

Codes

<>15Suspended - investigation with field
<>7Approved as submitted
<>CLClosed
<>25Predetermination Pricing Only - No Payment
<>28Repriced
<>13Suspended
<>14Suspended - incomplete claim
<>ROReopened
<>ADAdditional
<>22Reversal of Previous Payment
<>19Processed as Primary, Forwarded to Additional Payer(s)
<>RBReissue
<>29Audited
<>CPOpen
<>12Rejected, please resubmit with corrections
<>30Processed as Conditional
<>17Suspended - review pending
<>RCReopened and Closed
<>1Processed as Primary
<>23Not Our Claim, Forwarded to Additional Payer(s)
<>18Suspended Product Registration
<>4Denied
<>26Documentation Claim - No Payment Associated
<>16Suspended - return with material
<>2Processed as Secondary
<>20Processed as Secondary, Forwarded to Additional Payer(s)
<>5Pended
<>27Reviewed
<>8Cancelled due to inactivity
<>CCWeekly Certification
<>11Rejected, duplicate claim
<>RAReaudited
<>3Processed as Tertiary
<>21Processed as Tertiary, Forwarded to Additional Payer(s)
<>24Transferred to Proper Carrier
<>RDRedetermination
<>6Approved as amended
<>9Pending - under investigation
<>10Received, but not in process
<>APAppealed
<>IInitial