CAS Claims Adjustment

Batch

To supply adjustment reason codes and amounts as needed for an entire claim or for a particular service within the claim being paid

Elements

PositionElementNameTypeMin/MaxRepeat
11033Claim Adjustment Group CodeMandatoryID1/21
21034Claim Adjustment Reason CodeMandatoryID1/515
3782Monetary AmountMandatoryDecimal1/181
4380QuantityOptDecimal1/151
51034Claim Adjustment Reason CodeRelID1/51
6782Monetary AmountRelDecimal1/181
7380QuantityRelDecimal1/151
81034Claim Adjustment Reason CodeRelID1/51
9782Monetary AmountRelDecimal1/181
10380QuantityRelDecimal1/151
111034Claim Adjustment Reason CodeRelID1/51
12782Monetary AmountRelDecimal1/181
13380QuantityRelDecimal1/151
141034Claim Adjustment Reason CodeRelID1/51
15782Monetary AmountRelDecimal1/181
16380QuantityRelDecimal1/151
171034Claim Adjustment Reason CodeRelID1/51
18782Monetary AmountRelDecimal1/181
19380QuantityRelDecimal1/151

Element Details

ID1033
NameClaim Adjustment Group Code
LengthMin 1 / Max 2
Position1
RequirementMandatory
Codes
  • <>NC
    Disallowed charges and noncovered services
  • <>RR
    Regulatory Requirement
  • <>DE
    Denials
  • <>MA
    Medicare Adjustments
  • <>CO
    Contractual Obligations
  • <>PR
    Patient Responsibility
  • <>OA
    Other adjustments
  • <>CR
    Correction and Reversals
  • <>PI
    Payor Initiated Reductions