Segment
X12 EDI Release 00401
To convey the status of a product service claim or claims or to supply adjustment reason codes and amounts as needed for an entire claim or for a particular item within the claim
Elements
  • PCS011029Claim Status Code
    ID
    O可选(Optional)

    Code identifying the status of an entire claim as assigned by the payor, claim review organization or repricing organization

    Codes (41)
  • PCS02559Agency Qualifier Code
    ID
    O可选(Optional)

    Code identifying the agency assigning the code values

    Codes (176)
  • PCS03822Source Subqualifier
    AN
    O可选(Optional)
    Min 1 / Max 15

    A reference that indicates the table or text maintained by the Source Qualifier

  • PCS041172Claim Response Reason Code
    ID
    O可选(Optional)

    Code identifying the detailed reason for the response

    Codes (27)
  • PCS05782Monetary Amount
    R
    O可选(Optional)
    Min 1 / Max 18

    Monetary amount

  • PCS06889Follow-up Action Code
    ID
    O可选(Optional)

    Code identifying follow-up actions allowed

    Codes (10)
  • PCS07559Agency Qualifier Code
    ID
    O可选(Optional)

    Code identifying the agency assigning the code values

    Codes (176)
  • PCS08822Source Subqualifier
    AN
    O可选(Optional)
    Min 1 / Max 15

    A reference that indicates the table or text maintained by the Source Qualifier

  • PCS091225Disposition Code
    AN
    O可选(Optional)
    Min 3 / Max 3

    Code specifying the disposition of removed part, subassembly, or assembly

  • PCS10352Description
    AN
    O可选(Optional)
    Min 1 / Max 80

    A free-form description to clarify the related data elements and their content

  • PCS11553Authorization Identification
    AN
    O可选(Optional)
    Min 1 / Max 4

    Identifier representing authorization of an unusual repair or some attendant condition