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Data Element
CLT193
CLT.003.193
Definition | Claim adjustment reason codes communicate why a service line was paid differently than it was billed. |
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Size | X(3) |
FLF Start Position | 149 |
FLF Stop Position | 151 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be 3 characters or less 2. Value must be in Line Adjustment Reason Code List (VVL) 3. Conditional 4. Value must be populated when the total paid amount is different from the total billed amount |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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CIP240 | CIP.003.240 | LINE-ADJUSTMENT-REASON-CODE | CIP00003 | CLAIM-LINE-RECORD-IP |
COT163 | COT.003.163 | LINE-ADJUSTMENT-REASON-CODE | COT00003 | CLAIM-LINE-RECORD-OT |
CRX117 | CRX.003.117 | LINE-ADJUSTMENT-REASON-CODE | CRX00003 | CLAIM-LINE-RECORD-RX |