EDI X12 00403 PCS Segment Schema | 知行 EDI 规范查询平台

Elements

PCS01 1029 Claim 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)
- 1Processed as Primary
- 2Processed as Secondary
- 3Processed as Tertiary
- 4Denied
- 5Pended
- 6Approved as amended
- 7Approved as submitted
- 8Cancelled due to inactivity
- 9Pending - under investigation
- 10Received, but not in process
- 11Rejected, duplicate claim
- 12Rejected, please resubmit with corrections
- 13Suspended
- 14Suspended - incomplete claim
- 15Suspended - investigation with field
- 16Suspended - return with material
- 17Suspended - review pending
- 18Suspended Product Registration
- 19Processed as Primary, Forwarded to Additional Payer(s)
- 20Processed as Secondary, Forwarded to Additional Payer(s)
- 21Processed as Tertiary, Forwarded to Additional Payer(s)
- 22Reversal of Previous Payment
- 23Not Our Claim, Forwarded to Additional Payer(s)
- 24Transferred to Proper Carrier
- 25Predetermination Pricing Only - No Payment
- 26Documentation Claim - No Payment Associated
- 27Reviewed
- 28Repriced
- 29Audited
- 30Processed as Conditional
- IInitial
- ADAdditional
- APAppealed
- CCWeekly Certification
- CLClosed
- CPOpen
- RAReaudited
- RBReissue
- RCReopened and Closed
- RDRedetermination
- ROReopened
PCS02 559 Agency Qualifier Code
ID
O可选(Optional)
Code identifying the agency assigning the code values
Codes (187)
- 10Alabama
- 11Alaska
- 12Arizona
- 13Arkansas
- 14California
- 15Colorado
- 16Connecticut
- 17Delaware
- 18District of Columbia
- 19Florida
- 20Georgia
- 21Hawaii
- 22Idaho
- 23Illinois
- 24Indiana
- 25Iowa
- 26Kansas
- 27Louisiana
- 28Kentucky
- 29Maine
- 30Maryland
- 31Massachusetts
- 32Michigan
- 33Minnesota
- 34Mississippi
- 35Missouri
- 36Montana
- 37Nebraska
- 38Nevada
- 39New Hampshire
- 40New Jersey
- 41New Mexico
- 42New York
- 43North Carolina
- 44North Dakota
- 45Ohio
- 46Oklahoma
- 47Oregon
- 48Pennsylvania
- 49Rhode Island
- 50South Carolina
- 51South Dakota
- 52Tennessee
- 53Texas
- 54Utah
- 55Vermont
- 56Virginia
- 57Washington
- 58West Virginia
- 59Wisconsin
- 60Wyoming
- 61Insurance Services Office (ISO)
- 62National Crime Information Center (NCIC)
- 64U.S. National Center for Health Statistics Commission of Professional and Hospital Activities
- 65Office of Workers Compensation Programs
- 66National Association of Convenience Stores
- 93Dun & Bradstreet
- 94Code Assigned by the Organization that is the Ultimate Destination of the Transaction Set
- A1American Land Title Association
- A2California Land Title Association
- A3Texas Land Title Association
- A4Assigned by Carrier
- AAAluminum Association
- ABAssigned by Buyer
- ACAmerican Conference of Government Industrial Hygienists (ACGIH)
- ADAgency Company Organization for Research and Development (ACORD)
- AEAdvertising Industry
- AGState Agency Assigned
- AHAmerican Industrial Hygiene Association (AIHA)
- AJReal Estate Information Industry
- ALNational Alcohol Beverage Control Association
- AMAmerican Medical Association
- APAmerican Petroleum Institute
- AQAmerican Public Works Association (APWA) One Call Systems International (OCSI)
- ASAssigned by Seller
- ATAmerican Society for Testing and Materials (ASTM)
- AWAmerican Welding Society (AWS)
- AXANSI Accredited Standards Committee, X12
- AYAmerican Yarn Spinners Association (AYSA)
- BABusiness and Institutional Furniture Manufacturer's Association (BIFMA)
- BETelcordia Technologies
- BFNational Business Forms Association
- BIBook Industry Systems Advisory Committee
- CAChemical Abstract Services (CAS)
- CBCopper and Brass Fabricators Council, Inc.
- CCNational Cotton Council of America
- CEConstruction Specification Institute (CSI) Extended
- CIChemical Industry Data Exchange (CIDX)
- CLCollision Industry Electronic Commerce Association (CIECA)
- CMCarbide Manufacturers
- COCounty Designator Code
- CRCommander - Rome Air Development Center
- CSConstruction Specification Institute (CSI)
- CUCommittee on Uniform Security Identification Procedures (CUSIP)
- CXNational Association of Corrosion Engineers (NACE)
- DAFood and Drug Administration (FDA)
- DDDepartment of Defense (Military Specifications)
- DEDrug Enforcement Administration
- DFDepartment of Defense (DoD)
- DIDeutsches Institut fur Normung (DIN)
- DLDefense Logistics Agency
- DNDepartment of the Navy
- DOUnited States Department of Transportation (DOT)
- DRHealthcare Distribution Management Association
- DSDefense Finance and Accounting Service (DFAS)
- DXUnited States Marine Corps
- DYDepartment of Air Force
- DZDepartment of Army
- EIElectronic Industries Association
- EPUnited States Environmental Protection Agency (EPA)
- ESEnvironment and Safety Data Exchange (ESDX)
- ETTemporary Help Industry
- EUElectric Utilities
- EXElectronics Industry Data Exchange (EIDX)
- FAFabric and Supplier Linkage Council (FASLINC)
- FCFederal Communications Commission (FCC)
- FDGS1 US, Inc.
- FGFederal Government
- FHFederal Highway Administration
- FIAmerican Furniture Manufacturers Association
- GCGraphics Communications Association
- GSGeneral Services Administration (GSA)
- GUNatural Gas Utilities
- HCCenters for Medicare and Medicaid Services
- HFHuman Factors and Ergonomics Society
- HIHealth Insurance Association of America
- HSDepartment of Health and Human Services
- HUDepartment of Housing and Urban Development
- IAInternational Agency for Research on Cancer (IARC)
- IBInternational Association of Industrial Accident Boards and Commissions
- ICInternational Air Transport Association (IATA)
- IMIron and Steel Standards Committee ISM
- INInternational Association of Corporation Administrators
- ISInternational Standards Organization
- JAJapanese Standards Association
- LALife and Annuity Industry Committee
- LBDepartment of Labor
- LILeasing Industry
- MAMortgage Bankers Association of America
- MBOffice of Management and Budget
- MCManufacturing Company
- MEAmerican Society of Mechanical Engineers (ASME)
- MIABCD - The Microcomputer Industry Association
- MPMaterial Safety Data Sheet (MSDS) Provider
- MSMilitary Standard
- MVAmerican Association of Motor Vehicle Administrators (AAMVA)
- NANational Insurance Crime Bureau (NICB)
- NBNational Association of Business and Educational Radio
- NCNational Council on Compensation Insurance
- NENational Electric Manufacturers Association (NEMA)
- NFNational Fire Protection Agency (NFPA)
- NGNational Auto Glass Specification (NAGS)
- NINational Institute of Occupational Safety and Health (NIOSH)
- NRNational Retail Merchants Association
- NSNational Center for State Courts
- NTNational Toxicology Program (NTP)
- NUUnited States Nuclear Regulatory Commission
- NWNewspaper Association of America
- OIOptical Industry
- OPOffice Products
- OSUnited States Occupational Safety and Health Administration (OSHA)
- PAAmerican Paper Institute
- PCPennsylvania Courts
- RNRosettaNet
- SASociety of Automotive Engineers, Inc. (SAE)
- SESerials Industry Systems Advisory Committee (SISAC)
- SLStudent Loan Guarantor
- SPAmerican Society for Automation in Pharmacy
- STAmerican Iron & Steel Institute
- TAAir Transport Association of America
- TBTextile Distributors Association, Inc.
- TCTextile Apparel Linkage Council (TALC)
- TDTransportation Data Coordinating Committee: Electronic Data Interchange Association (TDCC:EDIA)
- TITelecommunications Industry
- TMAmerican Textile Manufacturers Institute
- TPCanadian Freight Classification
- TRAmerican Trucking Associations
- TXAmerican Apparel Manufacturers Association
- UA(UN/SPSC) United Nations Products and Services Classification Code
- UCUnited States Courts
- UIIndustrial/Commercial (I/C) Electronic Data Interchange
- ULUnderwriters Laboratories
- UNUnited Nations (UN)
- UTUtility Industry Group
- VIVoluntary Inter-Industry Commerce Standard (VICS) EDI
- WHCanadian Workplace Hazardous Materials Information System (WHMIS)
- ZZMutually Defined
PCS03 822 Source Subqualifier
AN
O可选(Optional)
Min 1 / Max 15
A reference that indicates the table or text maintained by the Source Qualifier
PCS04 1172 Claim Response Reason Code
ID
O可选(Optional)
Code identifying the detailed reason for the response
Codes (35)
- DCDuplicate Charge
- EWExpired Warranty
- URUnauthorized Repair
- CDRCustomer Damage or Responsibility
- CMPCustomer Must Pay Deductible
- ELHExcessive Labor Hours
- ELRExcessive Labor Rate
- EPCExcessive Part Cost
- ESCExcessive Sublet Cost
- FRSFactory Required Service
- FWCFull Warranty Credit
- IISInsufficient Information Supplied
- IRSItem Reported as Stolen
- IWSInsufficient Warranty Information Supplied
- MAPManufacturer's Agreed Price
- MRAMileage Less Than Previously Stated
- NCRNo Charge Repair
- NDFNo Defect Found
- NEWNot Eligible for Warranty
- NOPNot Our Product
- NRINot a Recall Item
- NSBNot a Service Bulletin Item
- NWRNo Warranty Record
- ODROriginal Equipment Manufacturer (OEM) or Manufacturer's Responsibility
- PNPPart not Proper for Specified Repair
- PNRPart or Documentation Not Returned or Received Within Time Limit
- PRDPart Received Damaged Due to Dealer Poor Packaging
- PWAPartial Warranty Approved
- RDPRepair Description Does Not Agree With Product
- RDRRepair Facility's Responsibility
- SUBSubmitted Too Late
- UPRUnrelated To Previous Repair
- URFUnauthorized Repair Facility
- VPWVehicle Previously Wrecked, System Not Warranted
- WBSWarranted By Seller
PCS05 782 Monetary Amount
R
O可选(Optional)
Min 1 / Max 18
Monetary amount
PCS06 889 Follow-up Action Code
ID
O可选(Optional)
Code identifying follow-up actions allowed
Codes (10)
- CPlease Correct and Resubmit
- DResubmit Entire Claim
- EResubmit This Item Only
- NResubmission Not Allowed
- PPlease Resubmit Original Transaction
- RResubmission Allowed
- SDo Not Resubmit; Inquiry Initiated to a Third Party
- WPlease Wait 30 Days and Resubmit
- XPlease Wait 10 Days and Resubmit
- YDo Not Resubmit; We Will Hold Your Request and Respond Again Shortly
PCS07 559 Agency Qualifier Code
ID
O可选(Optional)
Code identifying the agency assigning the code values
Codes (187)
- 10Alabama
- 11Alaska
- 12Arizona
- 13Arkansas
- 14California
- 15Colorado
- 16Connecticut
- 17Delaware
- 18District of Columbia
- 19Florida
- 20Georgia
- 21Hawaii
- 22Idaho
- 23Illinois
- 24Indiana
- 25Iowa
- 26Kansas
- 27Louisiana
- 28Kentucky
- 29Maine
- 30Maryland
- 31Massachusetts
- 32Michigan
- 33Minnesota
- 34Mississippi
- 35Missouri
- 36Montana
- 37Nebraska
- 38Nevada
- 39New Hampshire
- 40New Jersey
- 41New Mexico
- 42New York
- 43North Carolina
- 44North Dakota
- 45Ohio
- 46Oklahoma
- 47Oregon
- 48Pennsylvania
- 49Rhode Island
- 50South Carolina
- 51South Dakota
- 52Tennessee
- 53Texas
- 54Utah
- 55Vermont
- 56Virginia
- 57Washington
- 58West Virginia
- 59Wisconsin
- 60Wyoming
- 61Insurance Services Office (ISO)
- 62National Crime Information Center (NCIC)
- 64U.S. National Center for Health Statistics Commission of Professional and Hospital Activities
- 65Office of Workers Compensation Programs
- 66National Association of Convenience Stores
- 93Dun & Bradstreet
- 94Code Assigned by the Organization that is the Ultimate Destination of the Transaction Set
- A1American Land Title Association
- A2California Land Title Association
- A3Texas Land Title Association
- A4Assigned by Carrier
- AAAluminum Association
- ABAssigned by Buyer
- ACAmerican Conference of Government Industrial Hygienists (ACGIH)
- ADAgency Company Organization for Research and Development (ACORD)
- AEAdvertising Industry
- AGState Agency Assigned
- AHAmerican Industrial Hygiene Association (AIHA)
- AJReal Estate Information Industry
- ALNational Alcohol Beverage Control Association
- AMAmerican Medical Association
- APAmerican Petroleum Institute
- AQAmerican Public Works Association (APWA) One Call Systems International (OCSI)
- ASAssigned by Seller
- ATAmerican Society for Testing and Materials (ASTM)
- AWAmerican Welding Society (AWS)
- AXANSI Accredited Standards Committee, X12
- AYAmerican Yarn Spinners Association (AYSA)
- BABusiness and Institutional Furniture Manufacturer's Association (BIFMA)
- BETelcordia Technologies
- BFNational Business Forms Association
- BIBook Industry Systems Advisory Committee
- CAChemical Abstract Services (CAS)
- CBCopper and Brass Fabricators Council, Inc.
- CCNational Cotton Council of America
- CEConstruction Specification Institute (CSI) Extended
- CIChemical Industry Data Exchange (CIDX)
- CLCollision Industry Electronic Commerce Association (CIECA)
- CMCarbide Manufacturers
- COCounty Designator Code
- CRCommander - Rome Air Development Center
- CSConstruction Specification Institute (CSI)
- CUCommittee on Uniform Security Identification Procedures (CUSIP)
- CXNational Association of Corrosion Engineers (NACE)
- DAFood and Drug Administration (FDA)
- DDDepartment of Defense (Military Specifications)
- DEDrug Enforcement Administration
- DFDepartment of Defense (DoD)
- DIDeutsches Institut fur Normung (DIN)
- DLDefense Logistics Agency
- DNDepartment of the Navy
- DOUnited States Department of Transportation (DOT)
- DRHealthcare Distribution Management Association
- DSDefense Finance and Accounting Service (DFAS)
- DXUnited States Marine Corps
- DYDepartment of Air Force
- DZDepartment of Army
- EIElectronic Industries Association
- EPUnited States Environmental Protection Agency (EPA)
- ESEnvironment and Safety Data Exchange (ESDX)
- ETTemporary Help Industry
- EUElectric Utilities
- EXElectronics Industry Data Exchange (EIDX)
- FAFabric and Supplier Linkage Council (FASLINC)
- FCFederal Communications Commission (FCC)
- FDGS1 US, Inc.
- FGFederal Government
- FHFederal Highway Administration
- FIAmerican Furniture Manufacturers Association
- GCGraphics Communications Association
- GSGeneral Services Administration (GSA)
- GUNatural Gas Utilities
- HCCenters for Medicare and Medicaid Services
- HFHuman Factors and Ergonomics Society
- HIHealth Insurance Association of America
- HSDepartment of Health and Human Services
- HUDepartment of Housing and Urban Development
- IAInternational Agency for Research on Cancer (IARC)
- IBInternational Association of Industrial Accident Boards and Commissions
- ICInternational Air Transport Association (IATA)
- IMIron and Steel Standards Committee ISM
- INInternational Association of Corporation Administrators
- ISInternational Standards Organization
- JAJapanese Standards Association
- LALife and Annuity Industry Committee
- LBDepartment of Labor
- LILeasing Industry
- MAMortgage Bankers Association of America
- MBOffice of Management and Budget
- MCManufacturing Company
- MEAmerican Society of Mechanical Engineers (ASME)
- MIABCD - The Microcomputer Industry Association
- MPMaterial Safety Data Sheet (MSDS) Provider
- MSMilitary Standard
- MVAmerican Association of Motor Vehicle Administrators (AAMVA)
- NANational Insurance Crime Bureau (NICB)
- NBNational Association of Business and Educational Radio
- NCNational Council on Compensation Insurance
- NENational Electric Manufacturers Association (NEMA)
- NFNational Fire Protection Agency (NFPA)
- NGNational Auto Glass Specification (NAGS)
- NINational Institute of Occupational Safety and Health (NIOSH)
- NRNational Retail Merchants Association
- NSNational Center for State Courts
- NTNational Toxicology Program (NTP)
- NUUnited States Nuclear Regulatory Commission
- NWNewspaper Association of America
- OIOptical Industry
- OPOffice Products
- OSUnited States Occupational Safety and Health Administration (OSHA)
- PAAmerican Paper Institute
- PCPennsylvania Courts
- RNRosettaNet
- SASociety of Automotive Engineers, Inc. (SAE)
- SESerials Industry Systems Advisory Committee (SISAC)
- SLStudent Loan Guarantor
- SPAmerican Society for Automation in Pharmacy
- STAmerican Iron & Steel Institute
- TAAir Transport Association of America
- TBTextile Distributors Association, Inc.
- TCTextile Apparel Linkage Council (TALC)
- TDTransportation Data Coordinating Committee: Electronic Data Interchange Association (TDCC:EDIA)
- TITelecommunications Industry
- TMAmerican Textile Manufacturers Institute
- TPCanadian Freight Classification
- TRAmerican Trucking Associations
- TXAmerican Apparel Manufacturers Association
- UA(UN/SPSC) United Nations Products and Services Classification Code
- UCUnited States Courts
- UIIndustrial/Commercial (I/C) Electronic Data Interchange
- ULUnderwriters Laboratories
- UNUnited Nations (UN)
- UTUtility Industry Group
- VIVoluntary Inter-Industry Commerce Standard (VICS) EDI
- WHCanadian Workplace Hazardous Materials Information System (WHMIS)
- ZZMutually Defined
PCS08 822 Source Subqualifier
AN
O可选(Optional)
Min 1 / Max 15
A reference that indicates the table or text maintained by the Source Qualifier
PCS09 1225 Disposition Code
AN
O可选(Optional)
Min 3 / Max 3
Code specifying the disposition of removed part, subassembly, or assembly
PCS10 352 Description
AN
O可选(Optional)
Min 1 / Max 80
A free-form description to clarify the related data elements and their content
PCS11 553 Authorization Identification
AN
O可选(Optional)
Min 1 / Max 4
Identifier representing authorization of an unusual repair or some attendant condition