C058 Adjustment Reason

To provide a reason and related explanation for a Health Care Claim or Service change in payment versus the original submitted charges

Batch

Elements

Position	Element	Name		Type	Min/Max	Repeat

C058-1	1034	Claim Adjustment Reason Code	Mandatory	ID	1/5	1
C058-2	1270	Code List Qualifier Code	Rel	ID	1/3	1
C058-3	1271	Industry Code	Rel	Alphanumeric	1/30	1
C058-4	1271	Industry Code	Rel	Alphanumeric	1/30	1
C058-5	1271	Industry Code	Rel	Alphanumeric	1/30	1
C058-6	1271	Industry Code	Rel	Alphanumeric	1/30	1
C058-7	1271	Industry Code	Opt	Alphanumeric	1/30	1

ID1034

NameClaim Adjustment Reason Code

LengthMin 1 / Max 5