Segment
X12 EDI Release 00302
To supply adjustment reason codes and amounts as needed for an entire claim or for a particular service within the claim being paid
Elements
  • CAS011033Claim Adjustment Group Code
    ID
    M必须(Mandatory)

    Code identifying the general category of payment adjustment.

    Codes (8)
  • CAS021034Claim Adjustment Reason Code
    ID
    M必须(Mandatory)
    Min 1 / Max 3

    Code identifying the detailed reason the adjustment was made.

  • CAS03782Monetary Amount
    R
    M必须(Mandatory)
    Min 1 / Max 15

    Monetary amount.

  • CAS04380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity.