Segment
X12 EDI Release 00603
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
  • RAS01782Monetary Amount
    R
    M必须(Mandatory)
    Min 1 / Max 18

    Monetary amount

  • RAS021033Claim Adjustment Group Code
    ID
    M必须(Mandatory)

    Code identifying the general category of payment adjustment

    Codes (9)
  • RAS03C058Adjustment ReasonM必须(Mandatory)
    1034127012711271127112711271
    • RAS03011034Claim Adjustment Reason Code
      ID
      M必须(Mandatory)
      Min 0 / Max 5

      Code identifying the detailed reason the adjustment was made

    • RAS03021270Code List Qualifier Code
      ID
      O可选(Optional)

      Code identifying a specific industry code list

      Codes (998)
    • RAS03031271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • RAS03041271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • RAS03051271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • RAS03061271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

    • RAS03071271Industry Code
      AN
      O可选(Optional)
      Min 1 / Max 30

      Code indicating a code from a specific industry code list

  • RAS04380Quantity
    R
    O可选(Optional)
    Min 1 / Max 15

    Numeric value of quantity