RAS Reason Adjustment

Opt

AtMax 99

To supply Claim Adjustment Reason Codes and amounts as needed for an entire claim or for a particular service within the claim being paid

Elements

Position	Element	Name		Type	Min/Max	Repeat

1	782	Monetary Amount	Mandatory	Decimal	1/18	AtMax 1
2	1033	Claim Adjustment Group Code	Mandatory	ID	1/2	AtMax 1
C058Adjustment ReasonMandatory AtMax 15
4	380	Quantity	Opt	Decimal	1/15	AtMax 1

ID782

NameMonetary Amount

LengthMin 1 / Max 18

Position1

RequirementMandatory